open access

Vol 56, No 6 (2005)
Original papers
Published online: 2006-06-26
Submitted: 2013-02-15
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Percutaneous ethanol injections in the treatment of secondary hyperparathyroidism

Krzysztof Kuzdak, Agnieszka Rybińska, Maciej Białas
Endokrynologia Polska 2005;56(6):891-896.

open access

Vol 56, No 6 (2005)
Original papers
Published online: 2006-06-26
Submitted: 2013-02-15

Abstract

Introduction: Renal insufficiency is the most common etiology of secondary hyperparathyroidism. In case of resistance for conservative treatment, methods of choice are surgical intervention or percutaneous ethanol injections.
Aim of the study: The aim of the study was to evaluate usefulness of percutaneous ethanol injection therapy in the treatment of patients with secondary hyperparathyroidism.
Material and methods: We performed percutaneous 96% ethanol injections under USG guideance in 51 patients: 22 women (mean age 49,6 years) and 29 men (46,6 yrs). The base level of parathormone was 689,35 pg/ml. We managed to visualize one parathyroid gland in 34 patients, 2 in 12, 3 in 5 patients. The mean volume of a single gland was 0,8 cm3. All the injections were performed with the use of needle number 6. We repeated injections in case of no effects. One injection was performed in 18 patients, 2 in 18, 3 in 13, 5 in 1 and 6 in 1 patient. Before and after the treatment patients were examined with USG, scintigraphy and densitometry. Serum levels of calcium (Ca), phosphorus (P), parathormone (PTH) and alkaline phosphatase (FA) activity were also obtained. The main criteria for success was decrease in parathormone level of 50% or more in comparison with pre-injection level or to less than 200 pg/ml.
Results: In the whole group of patients after the first month, positive results were observed in 67%. There were no changes in 23%, and PTH level increased in 10%. After 6 months-positive results in 53%, no change in 35% and increase in 12%. We noted the best results in patients with PTH less than 800 pg/ml – 72% of them had positive results after 1 as far as after the 6 month.
Conclusions: Percutaneous ethanol injections are valuable method of treatment of secondary hyperparathyroidism. The best results can be obtained if PTH level is less than 800 pg/ml, one parathyroid gland dominating over the rest is visualised in USG, and if patient responds after 1 or at least 2 injections.

Abstract

Introduction: Renal insufficiency is the most common etiology of secondary hyperparathyroidism. In case of resistance for conservative treatment, methods of choice are surgical intervention or percutaneous ethanol injections.
Aim of the study: The aim of the study was to evaluate usefulness of percutaneous ethanol injection therapy in the treatment of patients with secondary hyperparathyroidism.
Material and methods: We performed percutaneous 96% ethanol injections under USG guideance in 51 patients: 22 women (mean age 49,6 years) and 29 men (46,6 yrs). The base level of parathormone was 689,35 pg/ml. We managed to visualize one parathyroid gland in 34 patients, 2 in 12, 3 in 5 patients. The mean volume of a single gland was 0,8 cm3. All the injections were performed with the use of needle number 6. We repeated injections in case of no effects. One injection was performed in 18 patients, 2 in 18, 3 in 13, 5 in 1 and 6 in 1 patient. Before and after the treatment patients were examined with USG, scintigraphy and densitometry. Serum levels of calcium (Ca), phosphorus (P), parathormone (PTH) and alkaline phosphatase (FA) activity were also obtained. The main criteria for success was decrease in parathormone level of 50% or more in comparison with pre-injection level or to less than 200 pg/ml.
Results: In the whole group of patients after the first month, positive results were observed in 67%. There were no changes in 23%, and PTH level increased in 10%. After 6 months-positive results in 53%, no change in 35% and increase in 12%. We noted the best results in patients with PTH less than 800 pg/ml – 72% of them had positive results after 1 as far as after the 6 month.
Conclusions: Percutaneous ethanol injections are valuable method of treatment of secondary hyperparathyroidism. The best results can be obtained if PTH level is less than 800 pg/ml, one parathyroid gland dominating over the rest is visualised in USG, and if patient responds after 1 or at least 2 injections.
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Keywords

secondary hyperparathyroidism; parathyroid hormone; hypercalcemia; ethanol- therapeutic use

About this article
Title

Percutaneous ethanol injections in the treatment of secondary hyperparathyroidism

Journal

Endokrynologia Polska

Issue

Vol 56, No 6 (2005)

Pages

891-896

Published online

2006-06-26

Bibliographic record

Endokrynologia Polska 2005;56(6):891-896.

Keywords

secondary hyperparathyroidism
parathyroid hormone
hypercalcemia
ethanol- therapeutic use

Authors

Krzysztof Kuzdak
Agnieszka Rybińska
Maciej Białas

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