Abstract
A case of polycythemia vera complicated by chronic renal failure under maintenance hemodialysis requiring parathyroidectory (PTH) for secondary hyperparathyroidism (2° HPT) is reported.
A 62 year old female presented with 75000 white blood cells (WBC)/µl, 703×104 red blood cells (RBC)/µl, 23×104 platelets (PLT)/µl, hyperuricemia and hypertension in 1970 and the diagnosis of polycythemia vera was made. Hemodialysis was started in October 1974 for chronic renal failure. Blood cells in peripheral blood rapidly decreased in number after the beginning of dialysis, reaching the level of 10000∼20000 WBC/µl, and 150∼250×104RBC/µl. In August 1988, marked bone resorption in X-ray picture and high serum alkaline phosphatase and parathyroid hormone (PTH) noted along with 17400 WBC/µl, 370×104RBC/µl and 35.9×104PLT/µl.
After subtotal PTX removing 3.21g parathyroid gland, serum PTH rapidly fell. At 3 months after PTX, WBC rose to 23600/µl, RBC 372×104/µl and PLT 94.0×104/µl. At 6 months, WBC was to 31000/µl, RBC 429×104/µl and PLT 78.0×104/µl, suggesting an inhibitory action of PTH on not only RBC, but also WBC and PLT.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Massry, S. G.: Is parathyroid hormone a uremic toxin? Nephron. 19:125–130, 1977.
Massry, S. G.: Parathyroid hormone and the uremic manifestations. Contr. Nephrol. 20:84–91, 1980 (Karger, Basel)
Avram, M. M., Iancu, M., Marrow, P., Feinfeld, D. and Huatuco, A.: Uremic syndrome in man: new evidence for parathormone as a multisystem neurotoxin. Clin. Nephrol. 11:59–62, 1979.
Boxer, M., Ellman, L., Geller, R., and Wang, C.: Anemia in primary hyperparathyroidism. Archs intern. Med. 137:588–590, 1977.
Zingraff, J., Drüeke, T., Marrie, P., Man, N. K., Jungers, P. and Bordier, P.: Anemia and secondary hyperparathyroidism. Archs Intern. Med. 138:1650–1652, 1978.
Aurbach, G, D., Mallette, L. E., Patten, B. M., Heath, D. A., Doppman, J. L. and Bilezikian, J. P.: Hyperparathyroidism: Recent studies. Ann. Intern. Med. 79:566–581, 1973.
Barbour, G. L.: Effect of parathyroidectory on anemia in chronic renal failure. Archs. Intern. Med. 139:889–891, 1979.
Podjarny, E., Rathaus, M., Korzets, Z., Blum, M., Zevin, D. and Bernheim, J.: Is anemia of chronic renal failure related to secondary hyperparathyroidism? Archs. Intern. Med. 141:453–455, 1981.
Grützmacher, P., Radtke, H. W., Fassbinder, W., Koch, K-M. and Schoeppe, W.: Effect of secondary hyperparathyroidism on the anemia of end-stage renal failure.: In vivo and in vitro studies.: Proc. EDTA. 20:739–745, 1983.
Hodgkinson, A.: Biochemical aspects of primary hyperparathyroidism: An Analysis of 50 cases. Clin. Sci. 25:231–241, 1963.
Author information
Authors and Affiliations
About this article
Cite this article
Inoue, S., Shono, T., Shono, M. et al. A case of polycythemia vera complicated by chronic renal failure under hemodialysis requiring parathyroidectomy for secondary hyperparathyroidisim. J Bone Miner Metab 8, 19–23 (1990). https://doi.org/10.1007/BF02377369
Issue Date:
DOI: https://doi.org/10.1007/BF02377369