Detail
Article
Online article
FT
Medvik - BMC
  • Something wrong with this record ?

Parathyroidectomy in hyperparathyroidism-associated calciphylaxis in end-stage renal disease should be prompt and radical - a case report with two original therapeutic modifications and successful outcome

S. Dusilová Sulková, J. Horáček, E. Vykoukalová, R. Šafránek, A. Malá, V. Palička

. 2017 ; 60 (2) : 85-88.

Language English Country Czech Republic

Document type Case Reports, Journal Article

Persistent link   https://www.medvik.cz/link/bmc18021080

We present a case of severe calciphylaxis in both thighs and calves in a patient with end-stage renal disease and advanced secondary hyperparathyroidism with successful outcome after modified therapeutic approach. The cause of calciphylaxis is multifactorial. In our case, not only severe hyperparathyroidism and mediocalcinosis, but also medication (warfarin, calcium and active vitamin D) was involved. Because the initial conservative therapy was not successful, we indicated parathyroidectomy. However, we were not able to localize parathyroid glands and we contraindicated bilateral neck exploration due to the patient's critical status. Therefore, we decided for total thyroidectomy with total parathyroidectomy. Surgery was uncomplicated and histology confirmed that all four parathyroid glands were removed. The expected post-operative hypocalcaemia was asymptomatic and we did not use any calcium supplementation or vitamin D. Thyroid hormone replacement was easy. After surgery, the large and multiple subcutaneous defects started to heal. We achieved complete healing within several months of continuing dedicated care. There is no recurrence after three years. Prompt and radical surgical parathyroidectomy was extremely useful in our patient.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc18021080
003      
CZ-PrNML
005      
20180621133822.0
007      
ta
008      
180611s2017 xr a f 000 0|eng||
009      
AR
024    7_
$a 10.14712/18059694.2017.99 $2 doi
035    __
$a (PubMed)28976876
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xr
100    1_
$a Sulková, Sylvie, $u Academic Department of Internal Medicine, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic; Haemodialysis Centre, University Hospital Hradec Králové, Czech Republic $d 1954- $7 jn20000710614
245    10
$a Parathyroidectomy in hyperparathyroidism-associated calciphylaxis in end-stage renal disease should be prompt and radical - a case report with two original therapeutic modifications and successful outcome / $c S. Dusilová Sulková, J. Horáček, E. Vykoukalová, R. Šafránek, A. Malá, V. Palička
520    9_
$a We present a case of severe calciphylaxis in both thighs and calves in a patient with end-stage renal disease and advanced secondary hyperparathyroidism with successful outcome after modified therapeutic approach. The cause of calciphylaxis is multifactorial. In our case, not only severe hyperparathyroidism and mediocalcinosis, but also medication (warfarin, calcium and active vitamin D) was involved. Because the initial conservative therapy was not successful, we indicated parathyroidectomy. However, we were not able to localize parathyroid glands and we contraindicated bilateral neck exploration due to the patient's critical status. Therefore, we decided for total thyroidectomy with total parathyroidectomy. Surgery was uncomplicated and histology confirmed that all four parathyroid glands were removed. The expected post-operative hypocalcaemia was asymptomatic and we did not use any calcium supplementation or vitamin D. Thyroid hormone replacement was easy. After surgery, the large and multiple subcutaneous defects started to heal. We achieved complete healing within several months of continuing dedicated care. There is no recurrence after three years. Prompt and radical surgical parathyroidectomy was extremely useful in our patient.
650    _2
$a kalcifylaxe $x etiologie $x patologie $7 D002115
650    _2
$a následné studie $7 D005500
650    _2
$a lidé $7 D006801
650    _2
$a sekundární hyperparatyreóza $x komplikace $x etiologie $x chirurgie $7 D006962
650    _2
$a chronické selhání ledvin $x komplikace $7 D007676
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a paratyreoidektomie $x metody $7 D016105
650    _2
$a výsledek terapie $7 D016896
655    _2
$a kazuistiky $7 D002363
655    _2
$a časopisecké články $7 D016428
700    1_
$a Horáček, Jiří, $u 4th Department of Internal Medicine - Haematology, University Hospital Hradec Králové, Czech Republic; Academic Department of Internal Medicine, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic $d 1952- $7 nlk19990073252
700    1_
$a Vykoukalová, Eva $u Internal Medicine Centre, Regional Hospital Liberec, Czech Republic $7 _AN088255
700    1_
$a Šafránek, Roman, $u Academic Department of Internal Medicine, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic; Haemodialysis Centre, University Hospital Hradec Králové, Czech Republic $d 1976- $7 xx0038146
700    1_
$a Malá, Alena $u Haemodialysis Centre, University Hospital Hradec Králové, Czech Republic $7 xx0243412
700    1_
$a Palička, Vladimír, $u Institute of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Czech Republic $d 1946- $7 jn99240000830
773    0_
$w MED00010947 $t Acta Medica (Hradec Kralove) $x 1211-4286 $g Roč. 60, č. 2 (2017), s. 85-88
856    41
$u https://pubmed.ncbi.nlm.nih.gov/28976876 $y Pubmed
856    41
$u https://actamedica.lfhk.cuni.cz/media/pdf/am_2017060020085.pdf $y plný text volně přístupný
910    __
$a ABA008 $b A 3077 $c 1072 $y 4 $z 0
990    __
$a 20180611 $b ABA008
991    __
$a 20180619080252 $b ABA008
999    __
$a ok $b bmc $g 1311787 $s 1017952
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2017 $b 60 $c 2 $d 85-88 $i 1211-4286 $m Acta Medica $n Acta Med. (Hradec Král.) $x MED00010947
LZP    __
$b NLK118 $a Pubmed-20180611

Find record

Citation metrics

Archiving options