Hong Kong Journal of Nephrology
Volume 9, Issue 1 , Pages 45-49, April 2007

Transient Thyrotoxicosis After Parathyroidectomy in a Hemodialysis Patient with Secondary Hyperparathyroidism

  • Chieko Hamada

      Affiliations

    • Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
    • ,
  • Yuichi Tanaka

      Affiliations

    • Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
    • ,
  • Tomoko Sakamoto

      Affiliations

    • Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
    • ,
  • Kayo Kaneko

      Affiliations

    • Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
    • ,
  • Ichiyu Shou

      Affiliations

    • Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
    • ,
  • Mitsumine Fukui

      Affiliations

    • Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
    • ,
  • Masaki Fukazawa

      Affiliations

    • Department of Surgery, Juntendo University School of Medicine, Tokyo, Japan
    • ,
  • Yasuhiko Tomino

      Affiliations

    • Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Professor Yasuhiko Tomino, Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Fax: (+81) 3-5802-1064

A 51-year-old Japanese male had been maintaining hemodialysis for 20 years. He had advanced secondary hyperparathyroidism. He had total parathyroidectomy (PTX) and autotransplantation in 2003. After the operation, clinical and endocrinologic findings showed transient thyrotoxicosis. There was no immunologic finding compatible with Graves' disease and chronic thyroiditis. After PTX, radioisotope accumulation markedly decreased on 99mTcO4− thyroid gland scintigram and blood flow diminished on thyroid gland ultrasonogram. These findings absolutely recovered with the resolution of thyrotoxicosis within 1 month. It appears that disturbance of the microcirculation in the thyroid gland by manipulation during operation might be a cause of transient thyrotoxicosis after PTX. It is important to consider transient thyrotoxicosis as a complication of PTX in secondary hyperparathyroidism.

Key words:  chronic renal failure , parathyroidectomy , secondary hyperparathyroidism , thyrotoxicosis

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PII: S1561-5413(07)60009-X

doi:10.1016/S1561-5413(07)60009-X

Hong Kong Journal of Nephrology
Volume 9, Issue 1 , Pages 45-49, April 2007

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