Failed Switching off in the MIBI-Parathyroid Scintigraphy in a Dialyzed Patient with Secondary Hyperparathyroidism Responsive to Cinacalcet Therapy
| Autor: | Mario Piga, Andrea Galfré, Piergiorgio Bolasco, Alessandra Serra, Maurizio Loi |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Parathyroidectomy
medicine.medical_specialty lcsh:RC648-665 Cinacalcet medicine.diagnostic_test Endocrine and Autonomic Systems business.industry Calcimimetic Endocrinology Diabetes and Metabolism medicine.medical_treatment Ultrasound Urology Case Report Scintigraphy medicine.disease lcsh:Diseases of the endocrine glands. Clinical endocrinology Surgery Endocrinology medicine.anatomical_structure medicine Parathyroid gland Secondary hyperparathyroidism Hemodialysis business medicine.drug |
| Zdroj: | International Journal of Endocrinology International Journal of Endocrinology, Vol 2010 (2010) |
| ISSN: | 1687-8345 1687-8337 |
| DOI: | 10.1155/2010/206801 |
| Popis: | The aims of your case report is to show the predictivity ofTc99m-sestamibi (MIBI) scintigraphy and doppler ultrasound imaging on secondary hyperparathyroidism (SHPT) in a patient responsive to calcimimetic treatment. Moreover, it has been reported that calcimimetic has great potential in reducing the volume of the parathyroid gland. On the other hand, the MIBI scintigraphy is considered a crucial diagnostic procedure to monitor the response to therapy in terms of turnover and cellular metabolism; whereas, ultrasound to monitor the volume variation in response to treatment. It is described the case of a 73-year-old man on hemodialysis from 1995 for ESRD. Within 2 years the patient gradually developed SHPT with progressively increased iPTH up to 1,000 ρg/ml. The ultrasound, highlighted the presence of two parathyroid hyperplasia, confirmed by scintigraphy, showing focal increase uptake of sestamibi in the same anatomical areas. As a result of the patient's refusal to perform a parathyroidectomy, cinacalcet, was administered (65 mg overage daily dose). After a year of treatment, there was a striking decrease of iPTH (from 1300 to 57 ρg/ml, −95%); but, on the contrary to expectations, this positive metabolic outcome, was not followed by parathyroid changes in ultrasound and scintigraphic findings. |
| Databáze: | OpenAIRE |
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