The aim of this work is to draw the attention of otorhinolaryngologists to the advantages of early conservative treatment of children with hypertrophy of the nasopharyngeal tonsil - adenoids. In childhood, a significant part of the protective and informational functions lies on the pharyngeal tonsil, since it is in the path of inhaled air. Unfavourable environmental conditions exacerbate its functional failure. Pathology of the lymphopharyngeal ring is highly prevalent and occupies a leading place among ENT diseases in children. Each person has a certain own microflora on the nasal mucosa from birth. In most cases, monoflora is determined on the mucous membrane of the nasal cavity, and only 2-3% is due to the combination of two types of microbial and fungal flora. For more than twenty years, we have been using the tactics of a sparing effect on the mucous membrane when using medicinal mixtures on a protective basis. Conservative treatment of 245 children aged 3 to 6 years with grade 1 – 2 adenoiditis was carried out, which made it possible to avoid surgical intervention in this group of children. When choosing a drug mixture, the sensitivity of the microflora of the patient’s nasal cavity was considered according to the results of a smear from the mucous membrane. Adenoidectomy is an operation with potentially undesirable consequences for the whole body, therefore, effective timely conservative therapy can reduce the risks and harms of surgery for pediatric patients.

Introduction. Hypoparathyroidism after hyroidectomy is treated with oral calcium and vitamin-D supplements. Everyday prolonged use of calcium and vitamin D medications can lead sometimes to hypercalcemia that can cause Akute Kidney Injury (AKI) and Arterial Hypertension. We report on a clinical case of a man patient with postoperative hypoparathyroidism who presented with hypercalcemia, AKI and Chronic Kidney Disease (CKD) as a result of prolonged treatment with Dihydrotachysterol and calcium medications. Сlinical case. A male patient, 59 y.o., 11 years ago underwent total thyroidectomy, since that time was daily medicated with l-thyroxine 125-150 mcg, dihydrotachysterol 15 drops (approx. 0,62 mg), calcium in different forms without monitoring the blood and urine levels. He had high arterial pressure up to 200/120 mm Hg, treated with amlodipine 10 mg daily. After 5 years he took onemonth treatment with non-steroidal antiinflammatory drugs for pain relief because of a rib fracture. That time he underwent first AKI with full recovery. After 5 years a few AKI recurred with hypercalcemia. Dihydrotachysterol and calcium were cancelled, but since that time patient kept on getting non-prescribed Dihydrotachysterol and calcium in the same doses. After 1 year more in relapse series a puncture biopsy of the kidney showed nephrocalcinosis, chronic interstitial nephritis and CKD (С4А3) was diagnosed. The patient was treated successfully by dis-continuation of the above drugs, intravenous fluid administration and enhancement of calcium renal excretion. The patient is currently free of complaints for about 3 months. Сonclusion. It is important for clinicians to monitor calcium and 25-OH-D levels in blood serum during the prolonged treatment with calcium and vitamin D medications to prevent a hypercalcemia that can lead to AKI, CKD and other sever complications.