原发性甲状旁腺功能亢进症与严重高钙血症伴循环中1,25-二羟维生素D水平降低

Primary hyperparathyroidism and severe hypercalcemia with low circulating 1,25-dihydroxyvitamin D.

作者信息

Shaker J L, Krawczyk K W, Findling J W

机构信息

Department of Medicine, St. Luke's Medical Center, Milwaukee, Wisconsin 53215.

出版信息

J Clin Endocrinol Metab. 1990 Nov;71(5):1305-9. doi: 10.1210/jcem-71-5-1305.

DOI:10.1210/jcem-71-5-1305

PMID:2229288

Abstract

We report a postmenopausal woman with primary hyperparathyroidism (PHPT) and severe hypercalcemia while her total calcium intake was more than 2 g daily. Despite a markedly elevated intact PTH level, her serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] level was low (17 pmol/L; 7 pg/mL). With reduced calcium intake, her serum calcium normalized, and 1,25-(OH)2D increased to 122 pmol/L (51 pg/mL). At the same time, intact PTH decreased to 32% of the initial value. PHPT may be associated with low circulating 1,25-(OH)2D levels. Furthermore, low 1,25-(OH)2D levels in PHPT may be due to a direct effect of severe hypercalcemia and be reversible with correction of hypercalcemia.

摘要

我们报告了一名绝经后女性，患有原发性甲状旁腺功能亢进症（PHPT）且血钙严重升高，而她的每日总钙摄入量超过2克。尽管其完整甲状旁腺激素（PTH）水平显著升高，但其血清1,25 - 二羟基维生素D [1,25-(OH)2D]水平较低（17 pmol/L；7 pg/mL）。随着钙摄入量减少，她的血清钙恢复正常，且1,25-(OH)2D升至122 pmol/L（51 pg/mL）。与此同时，完整PTH降至初始值的32%。PHPT可能与循环中1,25-(OH)2D水平较低有关。此外，PHPT中1,25-(OH)2D水平较低可能是由于严重高钙血症的直接影响，且随着高钙血症的纠正可能是可逆的。