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ARTICLE |

Pathology and Ultrastructure of the Human Parathyroid Glands in Chronic Renal Failure

Sanford I. Roth, MD; Richard B. Marshall, MD
Arch Intern Med. 1969;124(4):397-407. doi:10.1001/archinte.1969.00300200009002.
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Since the classical studies of Castleman and Mallory,1 it has been universally recognized that severe renal disease results in hyperplasia of the parathyroid glands. This study and subsequent ones have confirmed the impression that the hyperplasia of the parathyroid glands resulted in clinical hyperparathyroidism, and to distinguish this process from that in which the defect lay initially in the parathyroid gland, the former has been termed "secondary hyperparathyroidism." Though the mechanisms are not clear, experimental studies have demonstrated that parathyroid hormone secretion and synthesis 2,3 and cellular proliferation of the parathyroid gland are controlled by the level of the ionized serum calcium.

This communication will describe the anatomical structure of the parathyroids in 200 patients with secondary hyperparathyroidism. This structure will be correlated with clinical symptoms and chemical values. An electron microscopic study of the parathyroids of a patient with severe secondary hyperparathyroidism resulting in osteitis fibrosis cystica will

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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