Department of Internal Medicine, Division of Endocrinology, American University of Beirut-Medical Center, Riad El Solh 1107 2020, Beirut, Lebanon.
Metabolism. 2012 Jun;61(6):762-75. doi: 10.1016/j.metabol.2011.11.001. Epub 2012 Jan 4.
Recurrent or persistent hyperparathyroidism is an uncommon yet challenging clinical problem, and parathyromatosis is one of its very rare causes. In this minireview, we review causes of recurrent hyperparathyroidism and all cases of parathyromatosis available in the literature. The clinical course of a case of parathyromatosis with the longest follow-up (1977-2011) is described. Similar cases reported between 1975 and the present are reviewed and analyzed to characterize the clinical presentation, course, and management of this rare condition. Parathyromatosis, which is benign parathyroid tissue seeding, has been detailed in 35 patients in the English literature. The majority were female subjects, with end-stage renal disease, in their fifth to sixth decade of life. In most cases, the diagnosis was made intraoperatively; and the condition was often refractory to surgery. A calcimimetic agent was used in 5 cases with end-stage renal disease; serum calcium and/or parathyroid hormone levels decreased in 4 subjects, but only one was reported to experience increments in bone density. Medical management combining a calcimimetic with a bisphosphonate may therefore be a preferred alternative.
复发性或持续性甲状旁腺功能亢进症是一种不常见但具有挑战性的临床问题，甲状旁腺腺瘤病是其非常罕见的原因之一。在这篇迷你综述中，我们回顾了复发性甲状旁腺功能亢进症的原因以及文献中所有甲状旁腺腺瘤病的病例。描述了一例具有最长随访时间（1977-2011 年）的甲状旁腺腺瘤病的临床过程。回顾和分析了 1975 年至目前为止报告的类似病例，以描述这种罕见疾病的临床表现、病程和治疗。甲状旁腺腺瘤病是良性甲状旁腺组织播散，在英语文献中详细描述了 35 例患者。大多数为女性，患有终末期肾病，年龄在 50 至 60 岁之间。大多数病例是在手术中诊断出来的，而且病情往往对手术有抗药性。在 5 例终末期肾病患者中使用了钙敏感受体激动剂；4 例患者的血清钙和/或甲状旁腺激素水平下降，但仅 1 例报告骨密度增加。因此，联合使用钙敏感受体激动剂和双膦酸盐的药物治疗可能是首选的替代方法。
