临床实践中的血钙正常原发性甲状旁腺功能亢进症：一种惰性疾病还是潜在威胁？
Normocalcemic primary hyperparathyroidism in clinical practice: an indolent condition or a silent threat?
作者信息
Marques Thyciara Fontenele, Vasconcelos Renata, Diniz Erik, Rêgo Daniela, Griz Luiz, Bandeira Francisco
机构信息
Division of Endocrinology and Diabetes, Hospital Agamenon Magalhães, Brazilian Ministry of Health, Universidade de Pernambuco, Medical School, Recife, PE, Brazil.
出版信息
Arq Bras Endocrinol Metabol. 2011 Jun;55(5):314-7. doi: 10.1590/s0004-27302011000500003.
OBJECTIVE
To describe the characteristics of normocalcemic primary hyperparathyroidism (NPHPT) in patients seen for osteoporosis evaluation.
PATIENTS AND METHODS
We examined the records of 156 women who came to the hospital to be screened for osteoporosis. Measurements of total calcium, PTH, 25-hydroxy vitamin D, and β-C-telopeptide were recorded. Bone mineral density and T-scores were evaluated by densitometry of the lumbar spine, femoral neck and distal one-third of the radius. The latter was only measured in patients with primary hyperparathyroidism. Nephrolithiasis and bone fractures were documented by a review of the medical records.
RESULTS
We identified 14 patients with NPHPT, accounting for 8.9% of the population studied. In the medical records, the occurrence of kidney stones was reported in 28.6% of the patients with NPHPT, in contrast with only 0.7% of the noncarriers. Regarding the presence of general fractures, 21.4% of the patients with NPHPT were affected versus 16.2% of noncarriers.
CONCLUSION
Data from our study suggest that NPHPT has a diverse phenotypic presentation, implying that this may not be an "indolent" disease.
目的
描述因骨质疏松评估前来就诊患者的血钙正常的原发性甲状旁腺功能亢进症（NPHPT）的特征。
患者与方法
我们检查了156名前来医院进行骨质疏松筛查的女性的记录。记录了总钙、甲状旁腺激素（PTH）、25-羟维生素D和β-C-端肽的测量值。通过腰椎、股骨颈和桡骨远端三分之一处的骨密度测定来评估骨矿物质密度和T值。后者仅在原发性甲状旁腺功能亢进症患者中测量。通过查阅病历记录肾结石和骨折情况。
结果
我们识别出14例NPHPT患者，占所研究人群的8.9%。在病历中，28.6%的NPHPT患者报告有肾结石发生，相比之下非携带者仅为0.7%。关于总体骨折的发生情况，21.4%的NPHPT患者受到影响，而非携带者为16.2%。
结论
我们研究的数据表明，NPHPT具有多种表型表现，这意味着它可能不是一种“惰性”疾病。
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