Secondary hyperparathyroidism and brown tumor in dialyzed patients

Secondary hyperparathyroidism is one of the most common complications of ch ronic renal failure (CRF). Its pathogenesis is multifactorial and still not completely understood. Pathological mechanism of hypocalcemia, hyperphosph atemia and calcitriol deficiency are basic characteristics of CRF and main reason for morphological changes in parathyroid glands and hyperparathyroid ism (HP). We present a case of a female patient born in 1975. At the age of 10, a urinary infection was diagnosed for the first time and treated. Six years later, a's nausea and vomiting started, CRF based on bilateral reflux was diagnosed and the patient. was included in the hemodialysis treatment. The patient was again examined in 1997, when biochemical parameters, inclu ding the level of parathyroid hormone, ultrasonography of the neck, scintig raphy of the skeleton and densitometry, revealed secondary HP. Parathyreoid ectomy was performed in 1998. During the, follow up period, a tumefaction o n, a ramus mandibulae dex. was noticed, which was cytologically diagnosed a s osteitis fibrosa, "brown tumor", a rare complication of the secondary HP. Surgery was performed and PHD was granuloma gigantocelulare. Prevention an d therapy of secondary HP is a problem that demands early actions to avoid possible complications.