A CASE OF AN INFANT ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS WHO MARKEDLY IMPROVED IN SUBJECTIVE SYMPTOMS AFTER TOTAL PARATHYROIDECTOMY AND AUTOTRANSPLANTATION

Abstract

Total parathyroidectomy and autotransplantation to treat secondary hyperparathyoidism (SHP) have been often performed on adult patients with a favor able result, but have rarely been reported in the pediatric literature.
We performed the above operations on a 4-year-7-month girl who was treated by continuous amburatory peritoneal dialysis (CAPD). The postoperative levels of serum calcium remained low in spite of oral calcium and Vitamin D₃ medication, and intravenous calcium administration. But an administration of calcium into CAPF fluid has been maintained the normal level of serum calcium. A calcium balance study conducted for 3 days starting the 24th postoperative day showed 391mg/day of calcium absorption.
The girl obtained a relief from the bone pain approximately 2 weeks after the operation and was able to run easily one and a half month after the operation.
Total parathyroidectomy and autotransplantation were considered to be an effective treatment for severe symptoms of osteodystrophy in infantile patients with chronic renal failure.