Recurrent Hyperparathyroidism Following Successful Four-Gland Parathyroidectomy and Normalization of Parathyroid Hormone in a Renal Transplant Patient
Bibliographic record
Abstract
Chronic kidney disease has an estimated prevalence of 10% in Australia and is predicted to rise in the coming years. Secondary hyperparathyroidism resulting from chronic kidney disease is an important cause of morbidity in these patients; and screening for secondary hyperparathyroidism is recommended in international guidelines. We present the case of a chronic kidney disease patient who developed recurrent hyperparathyroidism despite previous "total" parathyroidectomy and subsequent renal transplant. After targeted investigations he was diagnosed with an accessory parathyroid gland in his thorax, causing the recurrent hyperparathyroidism. He was managed with a thoracoscopic excision with a resultant drop in parathyroid hormone consistent with surgical cure. This case highlights the rare phenomenon of supernumerary and ectopic parathyroid glands. Cross sectional thoracic imaging can and should be used to detect and localize supernumerary glands not apparent at the time of original surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".