Abstract It is well recognized that a serious form of renal disease may result from hyperparathyroidism.1 It is also well established that chronic renal insufficiency frequently is associated with secondary hyperplasia of the parathyroid glands.2 On a priori grounds, therefore, one can reason that a paradoxic situation might exist wherein long-standing renal disease resulting from a parathyroid adenoma is so severe as to stimulate further overactivity of the other parathyroid glands. Actually this does occur. Johnson3 reported a case in which removal of a parathyroid adenoma was followed by death from hypertension and uremia four years later, at which time the remaining parathyroid glands showed enlargement and hyperplasia. The following case report is submitted because it is the first to our knowledge in which secondary parathyroid hyperplasia has been proved to coexist with a parathyroid adenoma. REPORT OF CASE A. C., a former insurance salesman, aged 50, entered References 1. Albright, F.; Baird, P. C., and Bloomberg, E.: Studies on Physiology of Parathyroid Glands: Renal Complications of Hyperparathyroidism , Am. J. M. Sc. 187:49-65, 1934.Crossref 2. Albright, F.; Drake, T. G., and Sulkowitch, H. W.: Renal Osteitis Fibrosa Cystica: Report of Case with Discussion of Metabolic Aspects , Bull. Johns Hopkins Hosp. 60:377-399, 1937. 3. Castleman, B., and Mallory, T. B.: Parathyroid Hyperplasia in Chronic Renal Insufficiency , Am. J. Path. 13:553-574, 1937. 4. Shelling, D. H., and Remsen, D.: Renal Rickets: Report of Case Showing Four Enlarged Parathyroids and Evidence of Parathyroid Hypersecretion , Bull. Johns Hopkins Hosp. 57:158-181, 1935. 5. Johnson, J. W., Jr.: Primary Hyperparathyroidism with Extensive Renal Calcification and Secondary Hyperplasia of the Parathyroids: Report of a Case , Am. J. Path. 15:111-123, 1939. 6. Drake, T. G.; Albright, F., and Castleman, B.: Parathyroid Hyperplasia in Rabbits Produced by Parenteral Phosphate Administration , J. Clin. Investigation 16:203-206, 1937.Crossref
Archives of Internal Medicine – American Medical Association
Published: Mar 1, 1941
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