Atypical cases of secondary hyperparathyroidism in patients with kidney disease and failure: case reports


Authors: Pokorná Anita 1;  Horáček Jiří 2;  Vávrová Jaroslava 3;  Chrobok Viktor 4;  Čelakovský Petr 4;  Šafránek Roman 1,5;  Ryba Miroslav 6;  Řehořková Pavla 7;  Pavlíková Ladislava 3;  Palička Vladimír 3;  Sulková Dusilová Sylvie 1,5
Authors‘ workplace: Hemodialyzační středisko FN Hradec Králové 1;  IV. interní hematologická klinika LF UK a FN Hradec Králové 2;  Osteocentrum, Ústav klinické biochemie a diagnostiky LF UK a FN Hradec Králové 3;  Klinika otorinolaryngologie a chirurgie hlavy a krku LF UK a FN Hradec Králové 4;  Katedra interních oborů LF UK v Hradci Králové 5;  Oddělení nefrologie a dialýzy, Krajská nemocnice Liberec, a. s. 6;  Endokrinologie MUDr. Řehořková s. r. o., Hradecká poliklinika III s. r. o., Hradec Králové 7
Published in: Clinical Osteology 2020; 25(1): 50-57
Category:

Overview

The text is focused on clinical and laboratory manifestations of secondary hyperparathyroidism, associated with chronic kidney disease and chronic renal failure. Presenting four our case reports, we demonstrate not only the complex and complicated „traditional“ SHPT pathogenesis associated with kidney disease, but also others involving and contributing factors and problems. First, in some patients, it may be difficult to properly recognize between primary and secondary hyperparathyroidism. Additionally, the role of vitamin D deficiency as the crucial factor in parathyroid gland stimulation is demonstrated. Also, the role of dialysis solution composition on parathyroid gland activity is described. All case reports are presented together with commentaries, which contain the pathophysiological explanation as well as the suggested therapeutic approach.

Keywords:

vitamin D – hyperparathyreosis – hyperplasia – parathyroidectomy – parathyroid adenoma – parathyroid gland – secondary kidney disease – kidney failure


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Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology
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