TERTIARY HYPERPARATHYROIDISM TREATED BY ULTRASONICALLY GUIDED PERCUTANEOUS FINE-NEEDLE ETHANOL INJECTION

Advanced renal failure is often accompanied by secondary and tertiary hyper parathyroidism. In tertiary hyperparathyroidism it is necessary to reduce the gland mass. The present study describes the response to treatment with percutanous injection of ethanol of enlarged parathyroi d nodules in 9 uremic patients. All had hypercalcemia, severely elevat ed serum levels of parathyroid hormone and ultrasonically detectable e nlarged parathyroid glands. Three patients did not respond to the trea tment. In the remaining 6 patients. serum values of total and ionized calcium were normalized and the serum values of parathyroid hormone we re reduced at least 30% after 18 months. Seven of the patients experie nced an improvement of symptoms. No complications were seen. We conclu de that treatment with ethanol injection can be used as an alternative to conventional parathyroidectomy to improve parathyroid status in se lected patients.