Tominaga Y, Namii Y, Haba T, Uchida K, Numano M, Tanaka Y,
Takagi H
Monoclonal proliferation of nodues in parathyroid
hyperplasia due to chronic renal failure
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:972 1995
In secondary hyperparathyroidism, nodular hyperplasia probably represents a
greater
dedifferentiation of normal parathyroid cells compared to diffuse
hyperplasia. The investigators
obtained parathyroid glands of renal failure patients undergoing a
parathyroidectomy. They found
that 4/4 glands with diffuse hyperplasia were polyclonal and 8/8 nodules and
3/3 of autografted
parathyroid tissues were monoclonal. The authors conclude that, in uremic
hyperparathyroidism,
initially parathyroid glands are diffusely hyperplastic and polyclonal, and
then under the continued
stimulation, some small nodules proliferate monoclonally and grow.
Comment: Confirmatory but the stimuli for transformation from
polylconal to monoclonal
growth remain speculative. See also the related paper listed in HDCN by Arnold et al.
(Delmez)
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