Alon U, Berkowitz D, Berant M
Division of Pediatric Nephrology, Children's Mercy Hospital, University of Missouri, Kansas City.
Child Nephrol Urol. 1992;12(1):47-50.
We report on a 7-week-old infant with idiopathic hypercalcemia, hypercalciuria and nephrocalcinosis. At the time of admission, serum concentrations of parathyroid hormone and 1,25(OH)2D3 were found to be inadequately high, and those of calcitonin and 24,25(OH)2D3 too low, relative to the hypercalcemia. Treatment with calcitonin normalized serum calcium concentrations within 4 days, and a 3-week course of thiazides combined with a decreased dietary calcium:phosphorus ratio corrected the hypercalciuria. A repeat profile of the calcium-regulating hormones done at the age of 5.5 months was normal. Based on the clinical course and the hormonal profiles, we hypothesize that the idiopathic infantile hypercalcemia in this patient could have resulted from a generalized maturational delay of calcium homeostasis. Treatment with calcitonin, therefore, seems to be the most appropriate way to control the hypercalcemia.
我们报告了一名7周大的患有特发性高钙血症、高钙尿症和肾钙质沉着症的婴儿。入院时，相对于高钙血症，发现甲状旁腺激素和1,25(OH)2D3的血清浓度升高不足，而降钙素和24,25(OH)2D3的血清浓度过低。使用降钙素治疗4天内血清钙浓度恢复正常，为期3周的噻嗪类药物治疗联合降低饮食中钙磷比纠正了高钙尿症。在5.5个月大时重复检测的钙调节激素指标正常。基于临床病程和激素指标，我们推测该患者的特发性婴儿高钙血症可能是由于钙稳态的普遍成熟延迟所致。因此，使用降钙素治疗似乎是控制高钙血症的最合适方法。
