二次性副甲状腺機能こう進症における異所性副甲状腺に対しＰＣＩＴ（ｐｅｒｃｕｔａｎｅｏｕｓ ｃａｒｃｉｔｒｉｏｌ ｉｎｊｅｃｔｉｏｎ ｔｈｅｒａｐｙ）が有効であった１症例
書誌事項
- タイトル別名
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- A case of secondary hyperparathyroidism in which percutaneous calcitriol injection therapy (PCIT) was effective for ectopic parathyroid gland.
抄録
The patient was a 65-year-old male who started hemodialysis in 1978 after developed chronic renal insufficiency due to chronic glomerulonephritis. Therapy was changed to CAPD in 1996. Subtotal resection of the parathyroid and autotransplantation of the left leg were performed due to secondary hyperparathyroidism on April 20, 1994. After surgery, although the intact-PTH (i-PTH) level was reduced from 1422pg/ml to 75pg/ml, right recurrent nerve paralysis developed, and the patient consulted an outpatient clinic due to bone and joint pain on April 20, 1999. The i-PTH level was 751pg/ml. Blood was collected from both femoral veins, and the i-PTH levels were 738pg/ml and 762pg/ml from the right and left veins, respectively. Cervical ultrasonography showed a parathyroid tumor 4.9×3.6×5.4mm in size under the right clavicle in contact with the sternum. The presence of the tumor at this site was also confirmed by technetium-99m sestamibi (MIBI). Although 1, 25 (OH)2D2(VD) pulse therapy was conducted, it was not effective. Since the patient suffered from recurrent nerve paralysis, percutaneous calcitriol injection therapy (PCIT) was performed using Calcijex (2ug/ml) in accordance with the percutaneous ethanol injection therapy (PEIT) technique. A volume corresponding to 200% of the tumor volume was injected three times. After injection, pulse therapy with VD at 2ug twice a week was conducted. The i-PTH level decreased to 287pg/ml two weeks later and stabilized at 360pg/ml two months later. One year later, the level of i-PTH decreased to 60pg/ml, and no parathyroid tissue was observed by ultrasonography.
収録刊行物
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- 日本透析医学会雑誌
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日本透析医学会雑誌 34 (12), 1501-1504, 2001
一般社団法人 日本透析医学会
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詳細情報 詳細情報について
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- CRID
- 1390001204675172224
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- NII論文ID
- 130003875064
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- ISSN
- 1883082X
- 13403451
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
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- 抄録ライセンスフラグ
- 使用不可