Parathyroidectomy for Hypercalcemic Crisis in Renal Osteodystrophy
Authors: D. P. STABLES
Journal: Annals of Internal Medicine (1964)

Case Studies1 September 1964Parathyroidectomy for Hypercalcemic Crisis in Renal OsteodystrophyD. P. STABLES, M.B., B. CHIR., N. W. LEVIN, M.B., F.C.P. (S.A.), A. H. RUBENSTEIN, M.B., B. CH., M. E. BERK, M.B., F.F.R., D.M.R.D., C. ABRAHAMS, M.B., F.F. PATH. (S.A.)D. P. STABLES, M.B., B. CHIR.Search for more papers by this author, N. W. LEVIN, M.B., F.C.P. (S.A.)Search for more papers by this author, A. H. RUBENSTEIN, M.B., B. CH.Search for more papers by this author, M. E. BERK, M.B., F.F.R., D.M.R.D.Search for more papers by this author, C. ABRAHAMS, M.B., F.F. PATH. (S.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-3-531 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe concept of renal osteodystrophy, originally introduced by Liu and Chu (1), is now widely recognized, and the main features have been well described (2-4). Recalcification therapy with vitamin D has been observed to produce both symptomatic relief and radiological healing both of rickets and, in the majority of cases, of osteitis fibrosa, if the treatment is sufficiently prolonged (3, 5). Where, however, the changes of secondary hyperparathyroidism predominate and metastatic calcification is present, administration of vitamin D involves the risk of a further rise in the already high serum calcium-phosphorus product and, consequently, of a dangerous increase in metastatic...References1. LIUCHU SHHI: Studies of calcium and phosphorus metabolism with special reference to pathogenesis and effect of dihydrotachysterol (A.T.10) and iron. Medicine (Baltimore) 22: 103, 1943. CrossrefGoogle Scholar2. STANBURY SW: Azotaemic renal osteodystrophy. Brit. Med. Bull. 13: 57, 1957. CrossrefMedlineGoogle Scholar3. STANBURYLUMB SWGR: Metabolic studies of renal osteodystrophy. 1. Calcium, phosphorus and nitrogen metabolism in rickets, osteomalacia and hyperparathyroidism complicating chronic uremia and in the osteomalacia of the adult Fanconi syndrome. Medicine (Baltimore) 41: 1, 1962. CrossrefMedlineGoogle Scholar4. STANBURY SW: The bony complications of renal disease, in Renal Disease, edited by BLACK, D. A. K., Blackwell Scientific Publications, Oxford, 1962, pp. 508-552. Google Scholar5. DENTHARPERPHILPOT CECMGR: The treatment of renal glomerular osteodystrophy. Quart. J. Med. 30: 1, 1961. MedlineGoogle Scholar6. STANBURYLUMBNICHOLSON SWGAWF: Elective subtotal parathyroidectomy for renal hyperparathyroidism. Lancet 1: 793, 1960. CrossrefMedlineGoogle Scholar7. FINDLEYMOOREBRACKNEY TJDEL: Subtotal parathyroidectomy for renal hyperparathyroidism. Lancet 2: 1150, 1961. CrossrefGoogle Scholar8. ANDERSONMANNKENYONFARRELLHILLS WWJBNJJAG: Subtotal parathyroidectomy in azotemic renal osteodystrophy. New Eng. J. Med. 268: 575, 1963. CrossrefMedlineGoogle Scholar9. Case Records of the Massachusetts General Hospital. New Eng. J. Med. 268: 943, 1963. CrossrefGoogle Scholar10. GILMOUR JR: The parathyroid glands and skeleton in renal disease. Oxford Medical Publications, London, 1947. Google Scholar11. KENNEDYLINTONEATON ACALJC: Urea levels in cerebrospinal fluid after hemodialysis. Lancet 1: 410, 1962. CrossrefMedlineGoogle Scholar12. HUBBARDWENTWORTH RSJA: A case of metastatic calcification associated with chronic nephritis and hyperplasia of the parathyroids. Proc. Soc. Exp. Biol. Med. 18: 307, 1921. CrossrefGoogle Scholar13. SMYTHGOLDMAN FSL: Renal rickets with metastatic calcification and parathyroid dysfunction. Amer. J. Dis. Child. 48: 596, 1934. Google Scholar14. POLLAKSIEGAL HS: Parathyroid hyperplasia and calcinosis associated with renal disease. J. Mount Sinai Hosp. NY 2: 270, 1936. Google Scholar15. PRICEDAVIE NLTB: Renal rickets. Brit. J. Surg. 24: 548, 1936-1937. CrossrefGoogle Scholar16. BROWNGINSBERG CLIW: Osteoporosis associated with extensive metastatic calcification and chronic renal disease. Arch. Path. 30: 108, 1940. Google Scholar17. SNAPPER I: Recklinghausen's disease: hyperparathyroidism: parathyroid hyperplasia secondary to renal failure, in Medical Clinics on Bone Disease, Interscience Publishers, Inc., New York, 1949. Google Scholar18. HERBERTMILLERRICHARDSON FKHGGO: Chronic renal disease. Secondary parathyroid hyperplasia, decalcification of bone, and metastatic calcification. J. Path. Bact. 53: 161, 1941. CrossrefGoogle Scholar19. RICHARDS DG: Chronic renal disease with secondary hyperparathyroidism. Brit. Med. J. 1: 167, 1951. CrossrefMedlineGoogle Scholar20. JOINERTHORNE CLMG: On the occurrence of skeletal disorders in cases of long-standing renal failure. Guy Hosp. Rep. 102: 1, 1953. MedlineGoogle Scholar21. Clinicopathological conference. Amer. J. Med. 21: 117, 1956. MedlineGoogle Scholar22. SCHWARTZHEDGES TBRN: Hypercalcemia and hypocalcemia. DM, December, 1960. Google Scholar23. TALMAGETOFT RVRJ: The problem of the control of parathyroid secretion, in The Parathyroid, edited by GREEP, R. O., TALMAGE, R. V., Charles C Thomas, Springfield, Illinois, 1961, pp. 224-240. Google Scholar24. DENT CE: Discussions on the diagnosis of hyperparathyroidism. Proc. Roy. Soc. Med. 54: 639, 1961. CrossrefMedlineGoogle Scholar25. THOMASWISWELLCONNORHOWARD WCJGTBJE: Hypercalcemic crisis due to hyperparathyroidism. Amer. J. Med. 24: 229, 1958. CrossrefMedlineGoogle Scholar26. ROTHMUNGER SIBL: Cytology of adenomatous, atrophic and hyperplastic parathyroid gland of man: light- and electron-microscopic study. Virchow Arch. Path. Anat. 335: 389, 1962. CrossrefMedlineGoogle Scholar27. BEVERIDGEVAUGHANWALTERS BBFMN: Primary hyperparathyroidism and secondary renal failure with osteosclerosis. J. Fac. Radiol. (London) 10: 197, 1959. CrossrefGoogle Scholar28. SELYE H: On the stimulation of new bone formation with parathyroid extract and irradiated ergosterol. Endocrinology 16: 547, 1932. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Johannesburg,From the Departments of Medicine, Radiology, and Pathology, University of the Witwatersrand, and the Johannesburg General Hospital, Johannesburg, South Africa.Requests for reprints should be addressed to D. P. Stables, M.B., Department of Medicine, University of the Witwatersrand Medical School, Hospital Street, Johannesburg, South Africa. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRenal osteodystrophy in children: The effect of hemodialysis and renal homotransplantationThe parathyroids: Progress, problems and practiceTertiary hyperparathyroidism diagnosed after renal homotransplantationTotal parathyroidectomy in the treatment of renal osteodystrophyRenal Calcification in the Domestic CatMedical and Surgical Treatment of Azotemic OsteodystrophyJOHN H. FELTS, M.D., F.A.C.P., J. E. WHITLEY, M.D., D. D. ANDERSON, M.D., H. M. CARPENTER, M.D., H. H. BRADSHAW, M.D. 1 September 1964Volume 61, Issue 3Page: 531-539KeywordsCalciumDiagnostic radiologyFibrosisHospital medicineHyperparathyroidismParathyroidectomyPyelonephritisSpineVitamin D Issue Published: 1 September 1964 PDF downloadLoading ...