RT Journal
A1 Talwalkar YB, Puri HC, Hawker CC, Tseng C, Campbell JR, Campbell RA
T1 PArathyroid autotransplantation in 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 901
OP 905
DO 10.1001/archpedi.1979.02130090029004
UL http://dx.doi.org/10.1001/archpedi.1979.02130090029004
AB • Severe renal osteodystrophy with metaphyseal fractures developed in two children with hypoplastic-dysplastic kidneys and chronic renal failure despite therapy with vitamin D, CaCO3, phosphate-binding agents, and protein restriction. Serum immunoreactive parathyroid hormone (iPTH) levels were elevated to 709 and 1,537 pg/mL (N = 255 ± 92 pg/mL). Total parathyroidectomy and then autotransplantation of a small portion of parathyroids into the left brachioradialis muscle resulted in complete healing of renal osteodystrophy with the same dose of vitamin D. Serum iPTH and histological studies have demonstrated functioning parathyroid autotransplants, 19 and 20 months postoperatively in these two patients. Advantage of such a procedure over 3¾ parathyroidectomy is that this transplanted parathyroid tissue is easily accessible for partial removal in case of recurrence of uncontrollable hyperparathyroidism. We believe that total parathyroidectomy and autotransplantation can be successfully performed even in small children.(Am J Dis Child 133:901-905, 1979)