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Hyperparathyroidism and Medullary Sponge Kidney

Dhanwada S. Rao, MD; Boy Frame, MD; Melvin A. Block, MD; Alwyn M. Parfitt, MD
JAMA. 1977;238(18):1912-1913. doi:10.1001/jama.1977.03280190014007.
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To the Editor. —  Recently there have been a series of reports concerning the association of medullary sponge kidney (MSK) and primary hyperparathyroidism (PHPT).1-3 Our recent article1 summarized the case reports in the literature described thus far, although we were not aware of the case of Gremillion et al2 at that time. Since then, Beyer3 reported a case, and we have encountered yet another patient. This was a 25-year-old woman with recurrent calcium oxalate nephrolithiasis and hypercalciuria. Intravenous pyelogram (IVP) showed typical changes of MSK. At surgery three hyperplastic parathyroid glands that weighed a total of 660 mg were removed. Following surgery her urinary calcium level returned to normal, and she has not had any additional renal colic.With the present case, the total number of cases reported is ten, including four of our own patients. Certain important conclusions can be drawn from these cases. (1)


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