Autoinfarction of the parathyroid gland diagnosed by power Doppler ultrasonography in a patient with secondary hyperparathyroidism

Abstract

Spontaneous remission due to parathyroid infarction of secondary hyperparathyroidism (SHPT) [1,2] is very rare compared to that of primary hyperparathyroidism [3,4]. It is possible that the diagnosis of parathyroid infarction is missed in patients with SHPT because parathyroid infarction often occurs in only one of the enlarged glands. Lately, neck ultrasound examination has become a more beneficial and specific method for the diagnosis of enlarged parathyroid glands, in contrast to classic diagnostic techniques such as computed tomography (CT), magnetic resonance imaging (MRI) and scintigraphy [1,2]. The diagnosis of parathyroid infarction reported in previous studies, however, was often based on CT, MRI and scintigraphy findings and only a few studies have reported such diagnosis by emergency power Doppler ultrasonography of the neck. Here, we present a haemodialysis patient with autoinfarction of the left parathyroid gland diagnosed by emergency power Doppler ultrasonography of the neck. The spontaneous infarction of the parathyroid gland was associated with a small to moderate decrease in serum calcium and parathyroid harmone (PTH) values, but PTH remained markedly elevated. Case report