Nagasawa Motonori, Ubara Yoshifumi, Suwabe Tatsuya, Yamanouchi Masayuki, Hayami Noriko, Sumida Keiichi, Hattori Yoshinari, Tsukamoto Maki, Hiramatsu Eriko, Hasegawa Eiko, Hoshino Junichi, Sawa Naoki, Marui Yuji, Nakamura Michio, Tomikawa Shinji, Takaichi Kennmei
Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan.
Intern Med. 2012;51(24):3401-4. doi: 10.2169/internalmedicine.51.8055. Epub 2012 Dec 15.
We herein report an unusual case of spontaneous parathyroid gland rupture. A man was admitted with respiratory distress in September 2010. He had been receiving hemodialysis since 1995. He was diagnosed secondary hyperparathyroidism in 2006 and began receiving cinacalcet therapy in 2009. His intact parathyroid hormone (iPTH) level decreased, and massive traumatic bleeding occurred, following which rupture of the parathyroid gland was detected during surgery. The ruptured gland showed nodular hyperplasia. Previous reports have indicated that parathyroid bleeding is associated with glandular hypertrophy. This is the first report of parathyroid apoplexy occurring after suppression of elevated parathyroid function caused by cinacalcet therapy.
