Panuccio Vincenzo Antonio, Tripepi Rocco, Postorino Adele, Greve Bruna, Sabattini Elena, Oliva Esther Natalie
Nephrology, Dialysis and Transplantation Unit, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.
Institute of Clinical Physiology, National Research Council, Reggio Calabria, Italy.
Front Med (Lausanne). 2023 Feb 23;9:1050062. doi: 10.3389/fmed.2022.1050062. eCollection 2022.
Secondary hyperparathyroidism (SHPT) in dialysis is common. A young man on chronic hemodialysis with SHPT developed pancytopenia with resistant anemia requiring transfusions. A bone marrow biopsy showed grade 3 fibrosis, depleted cellularity, osteosclerosis, and decreased myelopoiesis. He initiated Etelcalcetide 7⋅5 mg 3 times weekly with improvement in SHPT concomitant with near normalization of blood counts. Marrow biopsy at 12 months showed clearance of marrow reticulin, improvement of osteosclerosis and normalization of bone trabeculae, cellularity and myelopoiesis. This is a unique case in which Etelcalcetide treatment is comparable to parathyroidectomy on SHPT and is associated with significant improvement in severe myelofibrosis.
透析患者中的继发性甲状旁腺功能亢进（SHPT）很常见。一名患有SHPT的慢性血液透析青年男子出现全血细胞减少症，伴有难治性贫血，需要输血治疗。骨髓活检显示3级纤维化、细胞减少、骨硬化和骨髓生成减少。他开始每周3次使用7.5毫克依特卡肽，SHPT症状有所改善，同时血细胞计数接近正常。12个月时的骨髓活检显示骨髓网状纤维清除、骨硬化改善以及骨小梁、细胞数量和骨髓生成正常化。这是一个独特的病例，其中依特卡肽治疗在SHPT方面与甲状旁腺切除术相当，并且与严重骨髓纤维化的显著改善相关。
