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[血钙正常的原发性甲状旁腺功能亢进症:一个日益严重的问题]

[Normocalcemic primary hyperparathyroidism: a growing problem].

作者信息

Martínez Díaz-Guerra Guillermo, Guadalix Iglesias Sonsoles, Hawkins Carranza Federico

机构信息

Servicio de Endocrinología y Nutrición, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España.

出版信息

Med Clin (Barc). 2013 Aug 4;141(3):125-9. doi: 10.1016/j.medcli.2012.09.025. Epub 2012 Nov 29.

Abstract

Normocalcemic primary hyperparathyroidism is at present one of the most common reasons for consultation in bone metabolism units. It is characterized by increased levels of intact parathyroid hormone in the presence of normal serum calcium (total and ionized) in generally asymptomatic individuals. The differential diagnosis should be considered in all situations that occur with secondary hyperparathyroidism. Its natural history is not well known, and it does not always progress to hypercalcemia. As a recently recognized entity, there are still no specific recommendations for its management. In this review we discuss some aspects of this entity, emphasizing the importance of a proper laboratory diagnosis, assessing possible signs or symptoms associated such as kidney stones or osteoporosis, which can help the clinician to take a conservative or interventionist attitude.

摘要

血钙正常的原发性甲状旁腺功能亢进目前是骨代谢科最常见的会诊原因之一。其特征是在一般无症状的个体中,血清总钙和离子钙水平正常的情况下,完整甲状旁腺激素水平升高。在所有继发性甲状旁腺功能亢进的情况下都应考虑鉴别诊断。其自然病程尚不清楚,并非总是会发展为高钙血症。作为一个最近才被认识的疾病实体,目前尚无针对其治疗的具体建议。在本综述中,我们讨论了该疾病实体的一些方面,强调了正确实验室诊断的重要性,评估可能相关的体征或症状,如肾结石或骨质疏松症,这有助于临床医生采取保守或干预性的态度。

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