Parathyroid Hyperplasia in Chronic Renal Insufficiency.
Parathyroid Hyperplasia in Chronic Renal Insufficiency.
复制标题
慢性肾功能不全的甲状旁腺增生。
DOI：
10.1097/00005053-193712000-00011
复制
发表时间：
1937
期刊：
影响因子：
--
通讯作者：
T. Mallory
中科院分区：
文献类型：
--
作者：
B. Castleman;T. Mallory
In contrast with the present universal recognition of the effects of parathyroid abnonnalities on the skeletal system relatively little attention has been devoted to the close interrelation of the kidneys and the parathyroid glands. Yet there is reason to believe that instances of the latter are far commoner than the former. For this relation appears to work in either direction. Hyperparathyroidism, if sufficiently long continued, will eventually lead to renal insufficiency because of calcium deposits in the kidney parenchyma, while primary renal insufficiency of a severe and prolonged character will produce parathyroid hyperplasia andif we accept as evidence the histological alterations in the bones and Shelling and Remsen's' parathormone assay of the bloodtrue functional hyperparathyroidism. Starting, therefore, with either primary lesion a patient may reach an apparently similar end-stage of combined hyperparathyroidism and renal i'nsufficiency. The possibility, therefore, of distinguishing between primary and secondary changes in the parathyroid gland has practical as well as theoretical significance. In a previous paper describing the pathology of the parathyroid glands in 25 cases of hyperparathyroidism 2 a classification was proposed that divided the lesions sharply into two groups, one in which the changes were restricted to one gland, part of a gland, or occasionally two glands (presumably neoplasia), and a second group in which diffuse hypertrophy and essentially uniform histological changes in all the glands occurreda condition we classified as hyperplasia. We described furthermore two types of hyperplasia; one in which all the cells are unusually large with clear cytoplasm and nuclei uniformly oriented to the base of the cell (true wasserhelle cells), and another type in which all the glands are composed, except for a scattering of oxyphil cells, of closely packed, normal sized chief cells. A single case of this chief cell type of hyperplasia was * Received for publication May 3, I937.
