三发性甲状旁腺功能亢进症(附一例报告)

Tertiary hyperparathyroidism (report of 1 case)

目的 探讨三发性甲状旁腺功能亢进症的临床特点。 方法 报告 1例三发性甲状旁腺功能亢进症患者的诊治经过。 结果 1例慢性肾衰患者 ,5年前因甲状旁腺腺瘤切除术后复发性甲状旁腺功能亢进而行甲状旁腺全切除加自体移植术。 3年前开始透析治疗 ,2年前成功接受肾移植。术后 2个月甲状旁腺功能亢进症状复发 ,3次切除自主性移植甲状旁腺腺体 ,3次复发 ,后于精神受刺激后自愈。 结论 三发性甲状旁腺功能亢进症可能在肾移植前已经存在。

Objective To study the pathogenetic characteristics of tertiary hyperparathyroidism. Methods The diagnosis and treatment of a male patient with tertiary hyperparathyroidism were reviwed. Results The patient who had had chronic renal failure underwent excision of the adenoma of parathyroid gland 5 year ago.After that,the total parathyroidectomy and autografting were performed because of his recurrent hyperparathyroidism.The patient began hemodialysis therapy 3 years ago and then underwent allogeneic kidney transplantation 2 years ago.Two months after the operation,symptomatic hyperparathyroidism relapsed.The autonomic parathyroid grafts were removed three times (one part of the grafts resected each time) with relapse occurring three times.Later the hyperparathyroidism was cured by itself after the patient was mentally irritated. Conclusions Tertiary hyperparathyroidism may have already developed before kidney transplantation.