Secondary hyperparathyroidism 

 in an Andean mummy 



James Blackman, Marvin J. Allison, Arthur C. Aufderheide, Norman Oldroyd, 



and R. Ted Steinbock 



While the idiopathic type of bladder stone seems to have 

 been more common in antiquity (Streitz et al. 1981), renal 

 urolithiasis has become more frequent with the industrial 

 revolution in western populations. The metabolic phenome- 

 na which led to bilateral, diffuse nephrocalcinosis and renal 

 calculus formation in an adolescent male a millennium ago 

 are presented together with the associated differential diag- 

 nosis. 



Materials and methods 



The spontaneously mummified body was excavated from a 

 burial site near the mouth of the Azapa Valley at Arica in 

 northern Chile. Associated burial goods identified it as a 

 member of the Cabuza culture population (a.d. 350-1000). 

 A total autopsy was carried out at the University of Tarapaca 

 (Arica, Chile) with final removal of all soft tissue and paleo- 

 pathological examination of the skeletal tissues. Following 

 gross examination ail identified soft tissue organs were 

 sampled for histologic and physicochemical studies. 



Flat plate bone x-rays were prepared of the skull, man- 

 dible, femurs, tibias, humeri, forearms, feet and hands, as 

 well as soft tissue films of both kidneys. 



Tissues for histologic studies were rehydrated and fixed in 

 4% formalin and in Ruffer's .solution, after which they were 

 processed in the same manner as routine surgical tissues, 

 dehydrated with organic solvents (alcohols, benzene, xylol), 

 embedded in paraffin and sectioned at four microns thick- 

 ness. Routine stains included hematoxylin and eosin, 

 Movat's pcntachrome and Gomori "s silver stain for reticulum 

 (Zimmerman 1976:59-61). 



Immunocytochemical studies for thyroid and parathyroid 

 antigens were performed on deparaffinizcd histologic sec- 

 tions using peroxidase-antiperoxidasc methods. Thyroid and 

 parathyroid antibodies and other reagents were supplied by 

 Biogenex Laboratories, Dublin, California. Positive controls 

 consisted of thyroid and parathyroid tissues from recent hos- 

 pital autopsies. 



Zagreb Paleopathology Symp. 1988 



Oxalate crystal identification studies were carried out on 

 deparaffinized tissue sections as described by Johnson and 

 Pani (1962). 



Renal stone analysis was performed by Norman Oldroyd 

 at the Louis C. Herring Laboratory in Orlando, Florida. 

 Methods included infrared spectro.scopy, x-ray ditTraction, 

 and crystallographic studies. 



Polarizing quality of tissue crystals was evaluated by ex- 

 amination of histologic sections with light microscopy using 

 polarizing filters. 



Hydrated, small (one-half millimeter) fragments of tissue 

 from the neck masses were studied by transmission electron 

 microscopy after glutaraldehyde fixation on a Phillips 201 

 transmission electron microscope (TEM). Both gross tissue 

 fragments and unstained histologic sections of the neck 

 masses and kidneys were examined in an Amray 1000 scan- 

 ning electron microscope (SEM) equipped with an electron 

 probe for element identification by energy dispersion x-ray 

 analysis (EDXA). 



Results 



GROSS SOFT TISSUE FINDINGS 



A large perforation of anthropogenic origin was found in 

 each ear lobe. In the Cabuza culture this signals an elite social 

 status (shaman?). Except for the spleen, the major organs 

 normally present in the thoracic and peritoneal cavities were 

 easily recognized and in their normal positions. Pathological 

 findings included a left lung dried in an expanded condition, 

 held in position by adhesions between the visceral and parie- 

 tal pleural surfaces over all aspects of both lobes. The right 

 lung was thin (2-3 mm) and collapsed, conforming to the 

 curvature of the posteromedial chest wall interior, an appear- 

 ance common for a normal lung in spontaneously mum- 

 mified bodies. The heart was of normal size, but much of the 

 visceral pericardial surface was covered with a thin ( 1 mm), 

 cream-colored layer of material which could not easily be 



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