Successful treatment of severe secondary hyperparathyroidsm (Brown tumor) by kidney transplantation and pulses of oral calcitriol.

Brown tumor is an extreme form of severe hyperparathyroid bone disease in end-stage renal disease patients. The evolution of the tumor after renal transplantation and under conservative treatment is still unclear. Herein, we report a 22-yr-old girl with parathyroid glandular hyperplasia because of an inadequate compliance and control of the mineral metabolism and subsequently developed Brown tumor of the ribs. A gradual improvement in bone and parathyroid gland status was observed within three yr following successful kidney transplantation and treatment with pulses of oral calcitriol. To the best of our knowledge, this is the first case of such severe secondary hyperparathyroidism with successful conservative treatment in the setting of kidney transplantation with no evidence of vascular calcifications and graft failure.