Tertiary hyperparathyroidism

Tertiary hyperparathyroidism develops in some patients with advanced renal Failure and some other rare diseases, such as X-linked hypophosphatemic rickets/osteomalacia, and they present hypercalcemia due to progression from appropriate Parathyroid hyperplasia to autonomous overproduction of PTH. If the Patient with end-stage renal disease undergoes renal transplantation, the Parathyroid gland hyperplasia subsides over a Period of months to years. In some patients, hypercalcemia may develop After renal transplantation, because correction of the renal Failure normalizes phosphate balance and increases calcitriol production, thereby raising serum Calcium concentrations transiently until the Parathyroid hyperplasia subsides. In some cases, Parathyroid hyperplasia may not resolve completely.

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