De Sanctis Vincenzo, Fiscina Bernadette, Ciccone Sara
Department of Reproduction and Growth, Pediatric and Adolescent Unit, Arcispedale St. Anna, Ferrara (Italy).
Pediatr Endocrinol Rev. 2010 Jun;7(4):363-5.
Long term administration of calcitriol (1,25 - dihydroxyvitamin D) is recommended for the treatment of a number of endocrine and renal disorders associated with impaired calcium - phosphate metabolism. Administration of calcitriol, however, may give rise to undesirable side effects, such as hypercalcemia and hypercalciuria. The magnitude of hypercalcemia is the key consideration in determining the need for immediate and aggressive therapy. There are four main strategies for lowering serum calcium: decreasing intestinal calcium absorption; increasing urinary excretion; decreasing bone resorption; and removing excess calcium through dialysis. We report on an adolescent with thalassemia who developed severe hypercalcemia during regular clinical follow-up for hypoparathyroidism treatment with calcitriol and calcium. He was also receiving levothyroxine for primary hypothyroidism and iron chelation therapy with desferioxamine mesylate for the severe iron overload.
建议长期使用骨化三醇（1,25 - 二羟维生素D）来治疗一些与钙磷代谢受损相关的内分泌和肾脏疾病。然而，使用骨化三醇可能会产生不良副作用，如高钙血症和高钙尿症。高钙血症的严重程度是决定是否需要立即进行积极治疗的关键考虑因素。降低血清钙有四种主要策略：减少肠道钙吸收；增加尿钙排泄；减少骨吸收；以及通过透析去除多余的钙。我们报告了一名患有地中海贫血的青少年，他在接受骨化三醇和钙治疗甲状旁腺功能减退症的定期临床随访期间出现了严重的高钙血症。他还因原发性甲状腺功能减退症接受左甲状腺素治疗，并因严重铁过载接受去铁胺的铁螯合治疗。
