CASE REPORT article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1564135
Recurrent secondary hyperparathyroidism after parathyroidectomy due to anterior mediastinum ectopic parathyroid in a peritoneal dialysis patient: A case report and review of the literature
Provisionally accepted
- 1Department of Nephrology, People’s Hospital of Deyang City, Deyang, China
- 2Department of Gastrointestinal Surgery, People’s Hospital of Deyang City, Deyang, Sichuan Province, China
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Background: Secondary hyperparathyroidism (SHPT) is a common complication of end-stage kidney disease (ESKD). Parathyroidectomy (PTX) is a reasonable option for patients with ESRD complicated with refractory SHPT, while few cases about ectopic parathyroid are reported in peritoneal dialysis patients.We report a case of recurrent SHPT after parathyroidectomy due to ectopic parathyroid in a patient undergoing long-term peritoneal dialysis for about 10 years. The ectopic parathyroid gland was found when performing the 1 st operation, but it was too risky to be removed and induced recurrent SHPT. The reoperation was successful with assistance of precise localization by 99m Tc-MIBI SPECT/CT imaging and sophisticated thoracoscopic surgical techniques. The patient received a calcium concentration of 1.75mmol/L dialysate in combination with adequate calcium and active vitamin D supplementation immediately after the 2 nd PTX, which resulted in remission of hungry bone syndrome (HBS) in a short time.Accurate evaluation of the position and function of the parathyroid gland before PTX is the key to reduce the rates of missed diagnosis and SHPT recurrence. Integrated management based on mineral metabolism assessment is essential for prevention and treatment of hungry bone syndrome after ectopic PTX in clinical practice.
Keywords: peritoneal dialysis1, ectopic parathyroid glands2, parathyroidectomy3, recurrent secondary hyperparathyroidism4, hungry bone syndrome5
Received: 21 Jan 2025; Accepted: 26 May 2025.
Copyright: © 2025 Cao, Qing, Ren and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haoyuan Ren, Department of Gastrointestinal Surgery, People’s Hospital of Deyang City, Deyang, Sichuan Province, China
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