Dattolo Pietro, Michelassi Stefano, Simone Giuseppina, Ferro Giuseppe, Pizzarelli Francesco
Nephrology and Dialysis Unit, S.M. Annunziata Hospital, Florence, Italy.
NDT Plus. 2010 Jun;3(3):276-278. doi: 10.1093/ndtplus/sfp190. Epub 2010 Feb 28.
Calcimimetics are effective in lowering serum parathyroid hormone (PTH) levels in hyperparathyroidism (HPT). However, they failed to reduce PTH levels in the long term in the setting of primary malignant HPT. A haemodialysis patient suffering from severe longstanding secondary HPT underwent total parathyroidectomy with autotransplantation of parathyroid tissue in her left arm. In the following years, she developed a severe HPT sustained by cancerous transformation of the parathyroid transplanted tissue and resistant both to pharmacological and repeated surgical treatments. The calcimimetic 'cinacalcet' was able to effectively reduce serum PTH levels over a 3-year follow-up and to induce disappearance of the neoplastic lesion on radionuclide imaging. Biochemical control of HPT was associated with a remarkable improvement in cardiac function.
拟钙剂在降低甲状旁腺功能亢进症（HPT）患者的血清甲状旁腺激素（PTH）水平方面有效。然而，在原发性恶性HPT的情况下，它们未能长期降低PTH水平。一名患有严重长期继发性HPT的血液透析患者接受了甲状旁腺全切除术，并将甲状旁腺组织自体移植到她的左臂。在接下来的几年里，她因甲状旁腺移植组织的癌变而发展为严重的HPT，对药物治疗和反复手术治疗均耐药。在3年的随访中，拟钙剂“西那卡塞”能够有效降低血清PTH水平，并使放射性核素成像上的肿瘤病变消失。HPT的生化控制与心脏功能的显著改善相关。
