BACKGROUND Persistent elevation of parathyroid hormone (PTH) levels following parathyroidectomy may indicate residual abnormal parathyroid tissue. OBJECTIVE To determine the clinical significance and risk factors for persistent PTH elevation following curative parathyroidectomy. METHODS A prospective study of consecutive patients with primary hyperparathyroidism who had resolution of hyperc...

Background: Calciphylaxis is a serious disorder often observed in dialysis patients and less frequently in chronic renal failure patients with secondary hyperparathyroidism. Mortality rate increases following the development of calciphylaxis, immediate application of parathyroidectomy along with other treatment options may be lifesaving. Case Presentation: A 44-year-old male patient had been...

BACKGROUND We describe a modification of the conventional subtotal parathyroidectomy operation where the parathyroid gland(s) remnant is repositioned with intact vascular supply to a plane superficial to the infrahyoid strap muscles and immediately under the skin incision. This technique called Subtotal Parathyroidectomy and Remnant Relocation (SPARE) retains all the metabolic advantages of the...

PURPOSE To report a case of autonomic, neurological and neuromuscular instability following methylene blue infusion for parathyroidectomy; to advance the argument for a diagnosis of serotonin syndrome; and to consider this diagnosis in previous, unexplained reports of adverse reactions amongst patients undergoing parathyroidectomy using methylene blue. CLINICAL FEATURES Methylene blue was adm...

Secondary hyperparathyroidism is a common complication for patients with end-stage renal disease (ESRD). When it progresses, it is associated with morbidity and mortality [1]. Phosphate binders and vitamin D can be used to prevent the progression of secondary hyperparathyroidism. However, these conservative treatments often fail to control severe hyperparathyroidism. In such cases, parathyroide...

Data on cardiovascular disease in primary hyperparathyroidism (PHPT) are controversial; indeed, at present, cardiovascular involvement is not included among the criteria needed for parathyroidectomy. Aim of this narrative review is to analyze the available literature in an effort to better characterize cardiovascular involvement in PHPT. Due to physiological effects of both parathyroid hormone ...

BACKGROUND Hungry bone syndrome (HBS) is an important postoperative complication after parathyroidectomy for severe secondary hyperparathyroidism (SHPT). There is, however, little data in the literature on its detailed clinical course, and the associated risk factors remain controversial. METHODS We did a single-center retrospective study on 62 consecutive dialysis patients who underwent tota...

BACKGROUND Intraoperative parathyroid hormone level (IOPTH) is withdrawn during parathyroidectomy to confirm the success of the procedure. Recently, the importance of IOPTH has been put to question. The purpose of this study is to determine whether IOPTH is necessary for all patients undergoing parathyroidectomy in the presence of frozen section. MATERIALS AND METHODS A cohort study of parath...

BACKGROUND Primary hyperparathyroidism (PHPT) with coexisting thyroid disease has been considered a contraindication to minimally invasive parathyroidectomy (MIP). This study assessed the impact of thyroid ultrasonography and guided fine-needle aspiration (FNA) biopsy with cytological review of the aspiration in distinguishing patients eligible for MIP from those requiring open parathyroidectom...

Sir, It is impressive to know that a serum phosphate level of >1.85mmol/l (5.7mg/dl) at 1 year after the start of dialysis may predict future need for parathyroidectomy [1]. Jorna et al. [1] also claim that the use of parathyroidectomy has not changed in recent years, perhaps trying to suggest that our management of secondary hyperparathyroidism remains inadequate. But data from the United Stat...