Kwon Ami, Koh Eun Sil, Chung Sungjin, Kim Yong Kyun
Department of Internal Medicine, The Catholic University of Korea Yeouido St. Mary's Hospital, Seoul, Republic of Korea.
BMJ Case Rep. 2013 Aug 1;2013:bcr2013010017. doi: 10.1136/bcr-2013-010017.
The differential diagnosis of hypercalcaemia in patients with end-stage renal disease undergoing dialysis should be considered for causes related or unrelated to renal failure itself or therapies for renal failure. In particular, peritoneal dialysis may hinder awareness of a clinical problem due to its own peculiarities and effects on homeostasis of the body, thus creating misconceptions in interpreting laboratory data and diagnosing a disease. We describe here a case of systemic sarcoidosis which was delayed due to failure to recognise underestimated hypercalcaemia in a patient undergoing peritoneal dialysis. Clinicians need to remain aware of the change of minerals that may arise from peritoneal dialysis and should perform an extensive investigation for the cause of hypercalcaemia.
对于正在接受透析的终末期肾病患者，高钙血症的鉴别诊断应考虑与肾衰竭本身或肾衰竭治疗相关或不相关的病因。特别是腹膜透析，由于其自身特点以及对机体稳态的影响，可能会妨碍对临床问题的认识，从而在解读实验室数据和诊断疾病时产生误解。我们在此描述一例系统性结节病病例，该病例因未识别出接受腹膜透析患者中被低估的高钙血症而被延误诊断。临床医生需要留意腹膜透析可能引起的矿物质变化，并应对高钙血症的病因进行全面调查。
