Presence of sonographically detectable parathyroid glands can predict resistance to oral pulsed-dose calcitriol treatment of secondary hyperparathyroidism

Surgical Treatment of Secondary Hyperparathyroidism due to Chronic Kidney Disease

“…Thus, when the gland has a volume of more than 300 mm 3 or a largest diameter of more than 1 cm, it is likely that the gland represents nodular hyperplasia. In these patients, 2HPT may be refractory to medical treatment, and PTx should be required (22)(23)(24).…”

Parathyroidectomy for Refractory Secondary Hyperparathyroidism with Severe Bone Disease

“…10 In addition, large glands that are detectable by ultrasound may be less likely to respond to medical treatment. 11 While the patient did not present with hypercalcemia, parathyroidectomy was considered the best treatment option because of progressive hyperparathyroid bone disease, persistently elevated PTH and phosphorus levels and unrelenting vitamin D deficiency. In this setting, PTHinduced release of phosphate from bone may have contributed to the persistent hyperphosphatemia, which precludes improvement with vitamin D.…”

Paratireoidectomia na DRC

“…[8][9][10][11][12][13][14] Embora a escolha de um tipo ou outro dependa da experiência e da habilidade do cirurgião, atualmente tem-se optado pela PTx subtotal ou total com autoimplante em razão da alta taxa de hipoparatireoidismo resultante da PTx total. 13 Não existe evidên-cia que a PTx total com autoimplante seja superior ou inferior à PTx subtotal.…”