Chosich N, Long F, Wong R, Topliss D J, Stockigt J R
Ewen Downie Metabolic Unit, Alfred Hospital, Melbourne, Vic, Australia.
J Endocrinol Invest. 1991 Jul-Aug;14(7):591-7. doi: 10.1007/BF03346877.
Hereditary hyperphosphatasia is a rare bone disorder characterized by increased bone turnover, elevated alkaline phosphatase (ALP) and bone deformity. We describe a patient with a mild form of hereditary hyperphosphatasia who was initially hypercalcemic in childhood with remission after puberty. Symptomatic hypercalcemia recurred during lactation after each of two pregnancies, associated with increased bone turnover (rise in ALP, osteocalcin, and urine hydroxyproline excretion) which appeared to be independent of changes in major calcium-regulating hormones. The mechanism for the development of post-partum hypercalcemia remains unclear but may relate to the relative estrogen deficiency of lactation. We postulate that acute estrogen withdrawal may result in hypercalcemia in the presence of markedly increased bone turnover.
遗传性高磷酸酶血症是一种罕见的骨骼疾病，其特征为骨转换增加、碱性磷酸酶（ALP）升高和骨骼畸形。我们描述了一名患有轻度遗传性高磷酸酶血症的患者，该患者在儿童期最初出现高钙血症，青春期后缓解。在两次怀孕后的哺乳期，症状性高钙血症均复发，同时伴有骨转换增加（ALP、骨钙素升高以及尿羟脯氨酸排泄增加），这似乎与主要钙调节激素的变化无关。产后高钙血症的发生机制尚不清楚，但可能与哺乳期相对雌激素缺乏有关。我们推测，在骨转换明显增加的情况下，急性雌激素撤退可能导致高钙血症。
