Cinacalcet in hyperparathyroidism management after pediatric renal transplantation

CEN Case Reports
Olivier NielGeorges Deschênes

Abstract

Secondary hyperparathyroidism is often associated with end stage renal disease; even after renal transplantation, hyperparathyroidism may persist, and is responsible for hypercalcemia, hypophosphatemia and elevated parathyroid hormone (iPTH) levels. Parathyroid hyperplasia is frequently associated with persistent hyperparathyroidism, and may require a surgical treatment. Here, we report hyperparathyroidism along with parathyroid hyperplasia in a 7-year-old child, which persisted after renal transplant. Calcitonin and pamidronate failed to decrease serum calcium levels; clodronate was also inefficient. Cinacalcet therapy normalized serum calcium and phosphorus levels, and decreased iPTH levels in 3 months; a severe parathyroid hyperplasia was also corrected under calcimimetic therapy. In conclusion, we report in a child that hypercalcemia associated with secondary hyperparathyroidism can be corrected with cinacalcet after pediatric renal transplantation. We also show that parathyroid hyperplasia can regress under calcimimetic therapy in a transplanted child, making surgery unnecessary.

References

Mar 3, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Pieter EvenepoelYves Vanrenterghem
Jan 28, 2005·Kidney International·Sharon M MoeKevin J Martin
Mar 4, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Geoffrey A BlockUNKNOWN TARGET Investigators
Feb 22, 2011·European Journal of Endocrinology·Andrea TrombettiRené Rizzoli
Apr 2, 2011·Clinical Journal of the American Society of Nephrology : CJASN·John CunninghamMariano Rodriguez
Sep 17, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P EvenepoelS Yue
Jul 16, 2015·Transplantation·Myles WolfFlavio Vincenti
Oct 30, 2015·Current Opinion in Endocrinology, Diabetes, and Obesity·Hee Jung JeonJaeseok Yang

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Citations

May 6, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Julie BernardorJustine Bacchetta

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