[一例特发性甲状旁腺功能减退患者维生素D中毒所致尿路结石病例]

[A case of urolithiasis due to vitamin D intoxication in a patient with idiopathic hypoparathyroidism].

作者信息

Ichioka Kentaro, Moroi Seiji, Yamamoto Shingo, Kamoto Toshiyuki, Okuno Hiroshi, Terai Akito, Terachi Toshiro, Ogawa Osamu

机构信息

Department of Urology, Faculty of Medicine, Kyoto University.

出版信息

Hinyokika Kiyo. 2002 Apr;48(4):231-4.

PMID:12048937

Abstract

We report a case of urolithiasis in a patient with idiopathic hypoparathyroidism treated with vitamin D therapy. A 30-year-old woman with idiopathic hypoparathyroidism, who had been treated with vitamin D therapy with 2-4 micrograms/day of alpha-calcidol for 9 years, was admitted for recurrence of bilateral renal stones and progressing left hydronephrosis. Laboratory data revealed normal serum calcium level and remarkable hypercalciuria. The dose of oral administration of alpha-calcidol was reduced to 1 microgram/day and 2 mg/day of trichlormethiazide was started. Now her serum calcium concentration and the total amount of urine calcium was completely under control. Bilateral renal stones are no longer progressive and tetany has not been recognized. We considered it essential to monitor closely not only the serum but also the urine calcium level in the vitamin D therapy for idiopathic hypoparathyroidism.

摘要

我们报告一例接受维生素D治疗的特发性甲状旁腺功能减退症患者并发尿路结石的病例。一名30岁患有特发性甲状旁腺功能减退症的女性，接受α-骨化醇每日2 - 4微克的维生素D治疗9年，因双侧肾结石复发及左侧肾积水进展入院。实验室检查数据显示血清钙水平正常，但有明显的高钙尿症。α-骨化醇的口服剂量减至每日1微克，并开始服用每日2毫克的三氯噻嗪。现在她的血清钙浓度和尿钙总量已完全得到控制。双侧肾结石不再进展，且未出现手足搐搦。我们认为在特发性甲状旁腺功能减退症的维生素D治疗中，密切监测血清和尿钙水平至关重要。