Divisão de Endocrinologia e Diabetes, Hospital Agamenon Magalhães - SUS, Universidade de Pernambuco, Recife, Brazil.
Endocr Pract. 2013 Mar-Apr;19(2):219-25. doi: 10.4158/EP12207.OR.
Some case reports have suggested primary hyperparathyroidism (PHPT) and peripheral polyneuropathy (PPN) are associated; however, there are no reports of studies examining this possible relationship. The aim of this study was to evaluate peripheral nerve conduction in subjects with PHPT.
The study involved 17 patients with PHPT. Mean patient age was 60.5 ± 12.9 years, serum calcium concentration was 11.5 ± 1.0 mg/dL, and the serum parathyroid hormone (PTH) level was 315 ± 569 pg/dL. The control group comprised 17 individuals without PHPT. The mean age of controls was 60.8 ± 12.5 years and the serum calcium concentration was 9.8 ± 0.3 mg/dL. Motor and sensory nerve conduction was assessed by electroneurography (ENG).
The following ENG parameters differed significantly between the PHPT and control groups: right (R) sural sensory nerve action potential conduction velocity (52.7 ± 6.3 m/s versus 58.0 ± 8.0 m/s; P = .041); R median compound muscle action potential (CMAP) amplitude (7.4 ± 1.6 mV versus 8.9 ± 1.7 mV; P = .002); R median CMAP latency (4.3 ± 1.2 ms versus 3.6 ± 0.6 ms; P = .032); R tibial CMAP latency (4.2 ± 1.1 ms versus 3.3 ± 0.4 ms; P = .001). The neurological examination was normal in all patients.
Our data demonstrate an association between PHPT and peripheral neurological alterations, consistent with subclinical sensory-motor PPN.
一些病例报告表明原发性甲状旁腺功能亢进症（PHPT）与周围多发性神经病（PPN）有关；然而，尚无研究报告对此可能的关系进行检查。本研究旨在评估 PHPT 患者的周围神经传导。
本研究纳入了 17 例 PHPT 患者。患者平均年龄为 60.5±12.9 岁，血清钙浓度为 11.5±1.0mg/dL，甲状旁腺激素（PTH）水平为 315±569pg/dL。对照组由 17 名无 PHPT 的个体组成。对照组的平均年龄为 60.8±12.5 岁，血清钙浓度为 9.8±0.3mg/dL。神经电图（ENG）评估运动和感觉神经传导。
PHPT 组和对照组之间以下 ENG 参数存在显著差异：右侧（R）腓肠感觉神经动作电位传导速度（52.7±6.3m/s 与 58.0±8.0m/s；P=0.041）；R 正中神经复合肌肉动作电位（CMAP）振幅（7.4±1.6mV 与 8.9±1.7mV；P=0.002）；R 正中神经 CMAP 潜伏期（4.3±1.2ms 与 3.6±0.6ms；P=0.032）；R 胫神经 CMAP 潜伏期（4.2±1.1ms 与 3.3±0.4ms；P=0.001）。所有患者的神经系统检查均正常。
我们的数据表明 PHPT 与周围神经改变之间存在关联，与亚临床感觉运动性 PPN 一致。
