Hiperparatiroidismo autónomo en paciente renal crónico estadio 3: valoración clínica a propósito de un caso

Diálisis y Trasplante Pub Date : 2013-10-01 DOI:10.1016/j.dialis.2013.06.002

Iara Dasilva Santos, Mónica María Furlano, César Emilio Ruiz García, María Jesús Lloret Cora, María del Carmen Guevara, Yaima Barreiro Delgado, Nadia Ayasreh Fierro, José Aurelio Ballarín, Jordi Bover Sanjuán

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引用次数: 6

Abstract

Primary –or autonomous– hyperparathyroidism is clinically characterized by the presence of non-pharmacological hypercalcemia with increased or inappropriately normal parathyroid hormone (PTH) levels. We hereby report the case of a 55-year-old woman with chronic kidney disease (CKD) stage 3bA3 who was diagnosed with autonomous hyperparathyroidism. We would like to stress that autonomous hyperparathyroidism is a not infrequent development in CKD patients, that its diagnosis is biochemical and that imaging techniques are only useful to localize hyperfunctioning parathyroid tissue but are not essential for diagnosis. We also review the current surgical criteria and therapeutic alternatives. Among these alternatives, medical treatment with cinacalcet probably deserves special consideration in several patient subgroups that are not candidates for surgery.

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慢性肾病患者自主甲状旁腺功能亢进3期:病例的临床评价

原发性或自发性甲状旁腺功能亢进的临床特征是存在非药物性高钙血症，甲状旁腺激素(PTH)水平升高或不正常。我们在此报告一例55岁女性慢性肾脏疾病(CKD) 3bA3期，她被诊断为自发性甲状旁腺功能亢进。我们想强调的是，自发性甲状旁腺功能亢进在CKD患者中并不罕见，其诊断是生化的，成像技术仅对定位甲状旁腺功能亢进组织有用，但对诊断不是必需的。我们也回顾了目前的手术标准和治疗方案。在这些替代方案中，cinacalcet的药物治疗可能值得特别考虑一些不适合手术的患者亚组。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Diálisis y Trasplante

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