{"created":"2023-05-15T11:23:25.371930+00:00","id":3012,"links":{},"metadata":{"_buckets":{"deposit":"bb0b4d83-aa26-4929-b013-e459707a0a08"},"_deposit":{"created_by":1,"id":"3012","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"3012"},"status":"published"},"_oai":{"id":"oai:showa.repo.nii.ac.jp:00003012","sets":["1:6:244:245"]},"author_link":["10402","10398","10401","10397","10399","10400","10396","10395"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-02"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"115","bibliographicPageStart":"110","bibliographicVolumeNumber":"79","bibliographic_titles":[{"bibliographic_title":"昭和学士会雑誌"}]}]},"item_10002_description_6":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"二次性副甲状腺機能亢進症は慢性腎臓病の重要な合併症であり，進行した場合には予後不良となる疾患である．内科的治療が第一選択であるが，intact-PTH（以下iPTH）がコントロール困難である症例では外科的治療である副甲状腺摘出術（以下PTx）が考慮される．しかしPTx後に残存腺や過剰腺腫大，初回手術時の副甲状腺播種，自家移植腺腫大により再発する症例がある．今回過剰腺かつ異所性副甲状腺による再発を認め，治療に難渋した症例を経験したので報告する．症例は38歳男性で，副甲状腺外科治療目的で当科へ紹介された．PTxを行う方針となり初回手術で4腺摘出するもiPTH値の再上昇を認めた．初回手術より1年11か月後に再手術を施行し5腺目を摘出したが，iPTH値は低下せず，シナカルセト内服を行いつつ再発病変の検索を行った．初回手術から7年後に右上頸部，縦隔に第6，7腺と思われる病変を認め異所性副甲状腺腫による再再発と診断し，初回手術より7年3か月後に3回目の手術を施行し6腺目を摘出した．PTx術後にiPTH値が低下しない症例では，過剰腺や異所性腺の可能性を念頭に置きながら潜在する副甲状腺過形成腺の存在部位をエコー，CT，MIBIシンチで定期的に探索することが重要である．","subitem_description_type":"Abstract"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"昭和大学学士会"}]},"item_10002_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"10.14930/jshowaunivsoc.79.110"}}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2187-719X"}]},"item_10002_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"内山, 美緒"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"門倉, 義幸"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"浅野, 雅世"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"北野, 学"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"川口, 顕一朗"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小倉, 千佳"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"粟倉, 秀幸"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小林, 一女"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-27"}],"displaytype":"detail","filename":"79_110.pdf","filesize":[{"value":"637.3 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"79_110.pdf","url":"https://showa.repo.nii.ac.jp/record/3012/files/79_110.pdf"},"version_id":"2cdb8d5f-00bd-4c4a-a5fb-0e45af034c95"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper"}]},"item_title":"治療に難渋した二次性副甲状腺機能亢進症の1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"治療に難渋した二次性副甲状腺機能亢進症の1例"}]},"item_type_id":"10002","owner":"1","path":["245"],"pubdate":{"attribute_name":"公開日","attribute_value":"2019-08-27"},"publish_date":"2019-08-27","publish_status":"0","recid":"3012","relation_version_is_last":true,"title":["治療に難渋した二次性副甲状腺機能亢進症の1例"],"weko_creator_id":"1","weko_shared_id":-1},"updated":"2023-05-15T12:35:00.193167+00:00"}