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原发性甲状旁腺功能亢进所致高钙血症危象与急性肾衰竭

[Hypercalcaemic crisis and acute renal failure due to primary hyperparathyroidism].

作者信息

Georges C G, Guthoff M, Wehrmann M, Teichmann R, Gröne E, Artunc F, Risler T, Friedrich B, Müssig K

机构信息

Abteilung für Endokrinologie, Diabetes, Angiologie, Nephrologie und Klinische Chemie, Medizinische Klinik, Universitätsklinikum Tübingen.

出版信息

Dtsch Med Wochenschr. 2008;133(Suppl 0):F3. doi: 10.1055/s-0028-1082823. Epub 2008 Dec 8.

Abstract

Hypercalcaemic crisis is a rare endocrine emergency. Often, an acute renal failure develops due to hypercalcaemia-induced polyuria. The molecular causes comprise stimulation of the calcium-sensing receptor in the ascending Henle loop and a reduced aquaporin expression in the collecting ducts. We report on a 54-year-old woman who was admitted for hypercalcaemic crisis and acute renal failure. Immediate rehydratation, bisphosphonate administration, and slow-extended daily dialysis (SLEDD) were initiated leading to a marked reduction of serum calcium. Endocrine work-up revealed primary hyperparathyroidism due to a parathyroid adenoma, which was treated by emergency surgery. Haemodialysis was continued in the first post-operative weeks for prolonged acute renal failure.

摘要

高钙血症危象是一种罕见的内分泌急症。通常,由于高钙血症引起的多尿会导致急性肾衰竭。其分子机制包括亨氏袢升支粗段钙敏感受体的刺激以及集合管中水通道蛋白表达的降低。我们报告了一名54岁因高钙血症危象和急性肾衰竭入院的女性患者。立即开始补液、给予双膦酸盐,并进行缓慢延长每日透析(SLEDD),导致血清钙显著降低。内分泌检查发现是由甲状旁腺腺瘤引起的原发性甲状旁腺功能亢进,通过急诊手术进行了治疗。术后最初几周因急性肾衰竭持续时间延长继续进行血液透析。

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