Abstract |
A 59-year-old woman with chronic renal failure due to type 2 diabetes mellitus (DM) is presented. Her father and a brother had a history of brain tumor. Her blood urea nitrogen and serum creatinine levels were 102 mg/dl and 4.5 mg/dl, respectively. Her serum Ca(2+) and Pi were within the normal range (9.4 mg/dl and 5.4 mg/dl, respectively). Her intact parathyroid hormone (PTH) level was 1 730 000 pg/ml. A (99m)Tc-methoxy-isobutylisonitrile scintigraphy showed high uptake in three parathyroid glands. A magnetic resonance image showed microadenoma in the pituitary gland. The serum gastrin level was high. Genetic examination revealed a mutation of the MEN1 gene (894-9 G --> A). From these findings, she was diagnosed with multiple endocrine neoplasia (MEN) type 1. Subsequently, a parathyroidectomy was performed successfully, a parathyroid gland was transplanted to her right forearm, and her serum Ca(2+) level was controlled at 8.5-9.0 mg/dl. It is very important to identify MEN1 if an end-stage renal disease ( ESRD) patient has hyperparathyroidism with multigland involvement. Examination of the MEN1 gene may be valuable to make an accurate diagnosis and choose the appropriate therapy in some ESRD patients with hyperparathyroidism.
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Authors | Hodaka Suzuki, Tetsuo Katoh, Yutaka Sakuma, Mitsuo Takahashi, Koichi Asahi, Shigeatsu Hashimoto, Shinji Kosugi, Shinichi Suzuki, Seiichi Takenoshita, Tsuyoshi Watanabe |
Journal | Clinical and experimental nephrology
(Clin Exp Nephrol)
Vol. 8
Issue 4
Pg. 380-3
(Dec 2004)
ISSN: 1342-1751 [Print] Japan |
PMID | 15619041
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Parathyroid Hormone
- Calcium
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Topics |
- Adult
- Calcium
(blood)
- Female
- Humans
- Hyperparathyroidism
(diagnosis, etiology, pathology, therapy)
- Kidney Failure, Chronic
(physiopathology)
- Male
- Middle Aged
- Multiple Endocrine Neoplasia Type 1
(diagnosis, genetics, physiopathology, therapy)
- Parathyroid Glands
(pathology, surgery)
- Parathyroid Hormone
(blood)
- Pedigree
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