Michigami Toshimi
Osaka Medical Center and Research Institute for Maternal and Child Health, Department of Bone and Mineral Research, Japan.
Clin Calcium. 2007 Aug;17(8):1186-91.
Serum level of parathyroid hormone (PTH) is strictly regulated by serum calcium concentration, which is sensed by the calcium-sensing receptor (CaSR) , a member of G-protein-coupled-receptor superfamily. Activating CaSR mutations result in the impaired PTH secretion and hypocalcemia, and the increased sensitivity of the receptor in kidney leads to relative hypercalciuria despite hypocalcemia. Recognizing the patients with activating mutations in CaSR is quite important, because these patients can exhibit unusual sensitivity to treatment of their hypocalcemia with calcium and vitamin D supplementation, with toxic effects including nephrocalcinosis, renal stones, and diminished renal function.
血清甲状旁腺激素(PTH)水平受血清钙浓度严格调控,血清钙浓度由钙敏感受体(CaSR)感知,CaSR是G蛋白偶联受体超家族的成员。激活CaSR的突变会导致PTH分泌受损和低钙血症,尽管存在低钙血症,但该受体在肾脏中的敏感性增加会导致相对高钙尿症。识别CaSR激活突变患者非常重要,因为这些患者对补充钙和维生素D治疗低钙血症可能表现出异常敏感性,会产生包括肾钙质沉着、肾结石和肾功能减退在内的毒性作用。