Błazejewska Agnieszka, Flisiński Mariusz, Pypkowski Jacek, Manitius Jacek
Wielospecjalistyczny Szpital Miejski w Bydgoszczy, Oddział Kardiologii i Rehabilitacji Kardiologicznej.
Pol Merkur Lekarski. 2009 Dec;27(162):484-7.
Primary hyperparathyroidism (PHPT) is a clinical state of excessive parathyroid hormone (PTH) secretion. The clinical profile of PHPT depends on duration of disease, PTH concentration, hypercalcemia and coexisting disorders. The symptoms associated with PHPT are neither typical nor specific. Asymptomatic PHPT is often diagnosed accidentally, based on laboratory results. The article presents case of 31-year old woman with chronic kidney disease (CKD) stage 4, persistent hypercalcemia, hypophosfataemia. Tertiary hyperparathyroidism (THPT) is most often situation when these disturbances occur but in this clinical situation CKD and PHPT is more likely. Paraendocrynopathy is also taken into consideration. Diagnostic methods estimate serum concentration of calcium and phosphate on each stage of CKD allowed to exclude THPT. Cinacalcet treatment followed by parathyroid surgery reduced serum calcium concentration.
原发性甲状旁腺功能亢进症（PHPT）是一种甲状旁腺激素（PTH）分泌过多的临床状态。PHPT的临床特征取决于疾病持续时间、PTH浓度、高钙血症及并存疾病。与PHPT相关的症状既不典型也不具有特异性。无症状性PHPT常根据实验室检查结果意外诊断。本文介绍了一名31岁患有慢性肾脏病（CKD）4期、持续性高钙血症、低磷血症的女性病例。当出现这些紊乱时，最常见的情况是 tertiary hyperparathyroidism（THPT），但在这种临床情况下，CKD和PHPT的可能性更大。内分泌病也在考虑范围内。通过在CKD各阶段评估血清钙和磷浓度的诊断方法排除了THPT。西那卡塞治疗后行甲状旁腺手术降低了血清钙浓度。 （注：文中“tertiary hyperparathyroidism”可能有误，暂未准确对应中文术语）
