[Parathyroid osteosis; parathyroidectomy].
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Between 1982 and 1990, 20 patients with chronic renal failure underwent total para-thyroidectomies and autotransplantations as treatment for secondary hyperparathyroidism. Fourteen cases were cured of their symptoms and their serum PTH levels was restored to normal. Recurrent hyperparathyroidism developed in 6 cases. In 3 of the 6 cases, excision of parathyroid tissue from the forearm could easily be performed under local anesthesia. Of the other cases, 2 had five and one had six glands. Several localizing methods should be performed before operation, in order to overlook the parathyroid glands in different anatomic positions.
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Soft-tissue calcification in chronic renal failure has been described, but little is understood about its pathogenesis or progression. Our patient's case is a dramatic example of complete resorption of soft-tissue juxta-articular calcification in secondary hyperparathyroidism after removal of parathyroid gland tissue. This resolution is most likely due to normalization of the calcium-phosphate ion product.
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