A case of secondary hyperparathyroidism whose high turnover bone improved after the direct injection of acetic acid into the parathyroid glands

Onoda, Noritaka; Kurihara, Satoshi; Sakurai, Yusei; Osono, Eiichi; Owada, Kazuhiro; Suga, Masaru; Adachi, Hideki; Yoneshima, Hideo

doi:10.5414/cnp61068

Cited by 9 publications

(5 citation statements)

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“…Several case reports and case series have been published. Percutaneous injection of ethanol [21,22], acetic acid [23] and calcitriol [24] and thermal ablation, including radiofrequency (RF) [25,26], laser [27] and high-intensity focussed ultrasound (HIFU) [28,29], have been assessed in patients with hyperparathyroidism. A preliminary study by our group also confirmed that ultrasound-guided MWA was safe and effective in destroying parathyroid gland tissue in patients with SHPT [15,16].…”

Section: Discussionmentioning

confidence: 99%

Microwave ablation of hyperplastic parathyroid glands is a treatment option for end-stage renal disease patients ineligible for surgical resection

Zhang

Peng

et al. 2019

International Journal of Hyperthermia

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Section: Discussionmentioning

confidence: 99%

Microwave ablation of hyperplastic parathyroid glands is a treatment option for end-stage renal disease patients ineligible for surgical resection

Zhang

Peng

et al. 2019

International Journal of Hyperthermia

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“…After PEIT, the PTH concentration gradually decreases, whereas after PTX it declines suddenly. The change in bone histology after surgical intervention is shown in Table 2; all cases of total PTX with forearm autograft have adynamic bone at 1 year after surgery, but the cases of subtotal PTX or PAIT (acetic acid injection) only show a shift to mild disorder (4).…”

Section: Clinical Differences Between Peit and Ptxmentioning

confidence: 99%

Parathyroid Interventions for Secondary Hyperparathyroidism in Hemodialyzed Patients

Onoda¹,

Kashiwagi²,

Nakamura³

et al. 2005

Ther Apher Dial

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Although parathyroidectomy (PTX) is the ultimate treatment for secondary hyperparathyroidism (SHPT) that is resistant to medical treatment, recent advances in ultrasonographic techniques have increased the treatment options in Japan. Percutaneous ethanol injection therapy (PEIT) of the parathyroid was approved under the national health insurance system in 2004, and there have been trials of direct injection of vitamin D (VD) preparations. We followed 30 patients for at least 1 year who had undergone PEIT at the same institution. The overall mean concentration of intact parathyroid hormone (PTH) fell from 865.3+/-388.4 pg/mL to 291.9+/-277.8 pg/mL, or 34% of the pretreatment value. The effect was even more pronounced for one or two glands, with 68.4% reaching the target of intact PTH

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“…In recent years, various percutaneous ablation techniques have been developed to treat patients with hyperparathyroidism, such as ethanol or acetic acid injection [16][17][18], laser ablation [19], high-intensity focused ultrasound treatment [20], radiofrequency ablation [21] and microwave ablation (MWA) [22]. More recently, studies have reported MWA as a successful effective nonsurgical alternative for treating SHPT [23,24].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of ultrasound-guided percutaneous microwave ablation for tertiary hyperparathyroidism

Zhi-an

Han

Chen

et al. 2019

International Journal of Hyperthermia

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Background: Tertiary hyperparathyroidism (THPT) is very common in hemodialysis patients with secondary hyperparathyroidism. However, a medical treatment is not indicated for THPT. Purpose: To investigate the feasibility, safety and efficacy of microwave ablation (MWA) in treating THPT. Materials and methods: Twenty-three patients with THPT were enrolled and treated with MWA. Clinical characteristics, serum levels of intact parathyroid hormone (iPTH), calcium, phosphorus and alkaline phosphatase (ALP), as well as treatment outcomes, were evaluated pre-and post-MWA. All patients were followed for >36 months for all assessable clinical data. Results: All patients successfully completed MWA. The mean follow-up was 47.0 ± 8.4 months. Immediately 1-day post-MWA, iPTH, calcium, phosphorus and ALP levels significantly decreased (all p < 0.001). During the long-term follow-up, iPTH levels increased gradually until 24 months and then remained at stable levels. After MWA, serum calcium reached stable levels at 24 months, while phosphorus and ALP reached stable levels at 6 months, and the levels were in the normal range or slightly higher than the upper normal limit. No obvious blood flow signals or significant recurrence was observed in the surgical nodules during follow-up. In the last follow-up, all nodules were persistent, but their maximum diameter and average volume were significantly lower after MWA (both p < 0.001), with an average reduction of 75.9 ± 11.3%. All patients had no major complications during MWA and follow-up. Conclusions: MWA is feasible, safe, effective and minimally invasive in treating THPT. Thus, MWA can be a nonsurgical alternative for treating THPT patients who are ineligible for surgery.

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A case of secondary hyperparathyroidism whose high turnover bone improved after the direct injection of acetic acid into the parathyroid glands

Cited by 9 publications

References 0 publications

Microwave ablation of hyperplastic parathyroid glands is a treatment option for end-stage renal disease patients ineligible for surgical resection

Microwave ablation of hyperplastic parathyroid glands is a treatment option for end-stage renal disease patients ineligible for surgical resection

Parathyroid Interventions for Secondary Hyperparathyroidism in Hemodialyzed Patients

Feasibility and safety of ultrasound-guided percutaneous microwave ablation for tertiary hyperparathyroidism

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