SEVERE HYPERPARATHYROIDISM ASSOCIATED WITH PROLONGED HUNGRY BONE SYNDROME IN A RENAL-TRANSPLANT RECIPIENT

Although widely believed to resolve within 6 to 12 months of successfu l renal transplantation, hyperparathyroidism may persist or develop af ter renal transplantation and eventually require parathyroidectomy. Av id calcium retention by demineralized bones (hungry bone syndrome) is well-recognized after parathyroidectomy and usually resolves after a f ew weeks. This report documents the case of a renal transplant recipie nt with persistent hyperparathyroidism who developed a pathological fr acture of the pelvis and required parathyroidectomy 1 year after trans plant and then manifested severe and prolonged hungry bone syndrome la sting for more than 20 months postoperatively. The clinical features a nd treatment of hyperparathyroidism in renal transplant recipients are discussed, as are diagnosis, pathogenesis, and management of hungry b one syndrome. Recognition of renal transplant recipients at greater ri sk for severe hungry bone syndrome should permit earlier and more aggr essive management of this sometimes protracted complication of parathy roid surgery.