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Saudi Journal of Kidney Diseases and Transplantation
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Year : 2016  |  Volume : 27  |  Issue : 4  |  Page : 822
Authors' reply

Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt

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Date of Web Publication5-Jul-2016

How to cite this article:
Youssef DM. Authors' reply. Saudi J Kidney Dis Transpl 2016;27:822

How to cite this URL:
Youssef DM. Authors' reply. Saudi J Kidney Dis Transpl [serial online] 2016 [cited 2022 Aug 7];27:822. Available from: https://www.sjkdt.org/text.asp?2016/27/4/822/185281
To the Editor ,

First, the letter mentioned that bone biopsy remains the "gold standard" diagnostic tool for various osseous lesions in ROD, including brown tumor. The author wondered why we did not attempt initially to perform a biopsy of the mandibular mass to hasten early diagnosis.

Performing bone biopsy is not always necessary to make a diagnosis of ROD in most situations in clinical practice and the treatment of brown tumor is mainly pharmalogic by treating the underlying HPT. [1]

Second, regarding parathyroidectomy, this has been found to stop maladaptive PTH stimulation. The level of intact parathormone (iPTH) in our patient was 602 pg/mL, serum calcium was 9.7 mg/dL, and phosphorus was 5 mg/dL. The Vitamin D level was low at 13 ng/mL and a medical trial of intensive course of intravenous active Vitamin D for three months until the iPTH was reduced to 52 pg/mL was attempted and medical therapy is often effective for the control of hyperparathyroidism (HPT). In general, it is felt that surgical parathyroidectomy is indicated only in the presence of severe HPT associated with hypercalcemia, which precludes further treatment with medical therapy, and/or hyperphosphatemia which also may preclude medical therapy with Vitamin D sterols. [2]

   References Top

KDOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 2002;39 Suppl 1:S1-246.  Back to cited text no. 1
Jakubowski JM, Velez I, McClure SA. Brown tumor as a result of hyperparathyroidism in an end-stage renal disease patient. Case Rep Radiol 2011;2011:415476.  Back to cited text no. 2

Correspondence Address:
Doaa M Youssef
Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-2442.185281

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