RT Journal
A1 BERGSTROM WH
T1 REnal osteodystrophy
JF American Journal of Diseases of Children
JO American Journal of Diseases of Children
YR 1979
FD September 1
VO 133
IS 9
SP 891
OP 893
DO 10.1001/archpedi.1979.02130090019002
UL http://dx.doi.org/10.1001/archpedi.1979.02130090019002
AB In this issue of the Journal (p 901), Talwalkar and his colleagues describe two young children with renal osteodystrophy resistant to phosphate restriction, calcium supplementation, and vitamin D therapy. After parathyroidectomy and partial autotransplantation, bone lesions healed promptly. After 20 months, roentgenograms and the serum immunoreactive parathyroid hormone (iPTH) level were normal. Three points of general interest derive from this article: (1) Medical management of renal osteodystrophy is sometimes unsatisfactory. (2) Partial parathyroidectomy may have gratifying clinical and biochemical results. (3) Autotransplantation, with convenient relocation of parathyroid remnants, facilitates evaluation of function and, if necessary, reoperation. The latter two points have been extensively discussed,1.2 and consensus favors the procedure so successfully used for the first time in children by Talwalkar's group. Pediatricians, however, will continue to be more concerned with the indications for parathyroid ablation than with the choice of procedure. The reasons for the occasional failure of