Brumsen C, Bloem R M, Papapoulos S E
Department of Endocrinology, University Hospital, Leiden, Netherlands.
Neth J Med. 1992 Jun;40(5-6):292-8.
A patient with extensive Paget's disease of bone presented with severe bone pain, hypercalcaemia and a large osteolytic lesion of the femur which developed during long-term therapy with etidronate. Treatment with pamidronate normalized serum calcium concentration and induced a complete biochemical remission. The osteolytic lesion was grafted with bone chips. A recurrence of the Paget's disease was associated with clear autonomous hypercalcaemic hyperparathyroidism. Five years after removal of 3 1/2 hyperplastic parathyroid glands, the patient remains in complete clinical and biochemical remission. These findings illustrate the pitfalls encountered in the management of Paget's disease and the value of combining medical and surgical interventions.
一名患有广泛骨Paget病的患者出现严重骨痛、高钙血症以及在长期依替膦酸治疗期间发生的股骨大溶骨性病变。帕米膦酸治疗使血清钙浓度恢复正常并诱导了完全的生化缓解。对溶骨性病变进行了骨屑移植。Paget病复发与明确的自主性高钙血症性甲状旁腺功能亢进相关。在切除3个半增生的甲状旁腺腺体5年后，患者仍处于完全的临床和生化缓解状态。这些发现说明了在Paget病管理中遇到的陷阱以及联合药物和手术干预的价值。
