霍奇金病中的间歇性高钙血症与维生素D敏感性
Intermittent hypercalcaemia and vitamin D sensitivity in Hodgkin's disease.
作者信息
Karmali R, Barker S, Hewison M, Fraher L, Katz D R, O'Riordan J L
机构信息
Department of Medicine, Middlesex Hospital, London, UK.
出版信息
Postgrad Med J. 1990 Sep;66(779):757-60. doi: 10.1136/pgmj.66.779.757.
A patient with Hodgkin's disease spontaneously developed steroid-responsive hypercalcaemia during two consecutive summers. Administration of 3000 U/day of vitamin D, while he was normocalcaemic, caused a sharp increase in serum 1,25(OH)2D3 (from 59 pg/ml to 142 pg/ml) and subsequently hypercalcaemia while serum 25(OH)D3 rose moderately within the normal range (from 2.8 ng/ml to 10 ng/ml). During a spontaneous episode of hypercalcaemia which was accompanied by increased circulating 1,25(OH)2D3 concentrations, administration of hydrocortisone decreased serum 1,25(OH)2D3 rapidly (from 115 pg/ml to 62 pg/ml) and eventually led to normocalcaemia while serum 25(OH)D3 remained unchanged. Thus the disturbances of mineral metabolism found in this patient with Hodgkin's disease are very similar to those previously described in sarcoidosis.
一名霍奇金病患者在连续两个夏天自发出现了对类固醇有反应的高钙血症。在他血钙正常时，每天给予3000单位维生素D导致血清1,25(OH)₂D₃急剧升高（从59 pg/ml升至142 pg/ml），随后出现高钙血症，而血清25(OH)D₃在正常范围内适度升高（从2.8 ng/ml升至10 ng/ml）。在一次伴有循环中1,25(OH)₂D₃浓度升高的高钙血症自发发作期间，给予氢化可的松迅速降低了血清1,25(OH)₂D₃（从115 pg/ml降至62 pg/ml），最终导致血钙正常，而血清25(OH)D₃保持不变。因此，该霍奇金病患者出现的矿物质代谢紊乱与先前在结节病中描述的非常相似。
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