Thyrotoxicosis Occurring in Secondary Hyperparathyroidism Patients Undergoing Dialysis after Total Parathyroidectomy with Autotransplantation

Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) that is characterized by excessive synthesis of parathyroid hormone (PTH) and parathyroid hyperplasia.[1] The prevalence of CKD is estimated to be 5–10%, and the burden of CKD‐associated diseases is alarmingly high.[2,3] Despite advances in medical therapy for SHPT, surgical parathyroidectomy remains the definitive therapy for refractory SHPT, which drastically decreases PTH levels and ameliorates symptoms related to severe SHPT.[4] Total parathyroidectomy, subtotal parathyroidectomy, or total parathyroidectomy with autotransplantation represents the current surgical options in the treatment of SHPT.[5] Total parathyroidectomy with autotransplantation may be preferable in patients who will require long‐term hemodialysis after surgery, and total parathyroidectomy without autotransplantation should be prohibited in patients who have a better chance of receiving kidney transplantation because of the risks of iatrogenic hypoparathyroidism and hypocalcemia after kidney transplantation.[4]