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原发性甲状旁腺功能亢进继发严重高钙血症

[Severe hypercalcemia secondary to primary hyperparathyroidism].

作者信息

Foppiani Luca, Antonucci Giancarlo, Scirocco Maria Concetta, Lione Sergio, Piccardo Arnoldo, Marinaro Eugenio, Catrambone Ugo, Lo Pinto Giuliano

出版信息

Recenti Prog Med. 2014 Feb;105(2):83-7. doi: 10.1701/1417.15702.

Abstract

Primary hyperparathyroidism is a common endocrinopathy which is nowadays diagnosed incidentally. Calcium levels range from "normal" to extremely high which can be life-threatening. We report the case of a female patient who was admitted to hospital for unspecific symptoms ultimately referable to severe hypercalcemia secondary to a large parathyroid tumor. After an intensive medical treatment (hydration, diuretics, steroids, bisphosphonate) leading to reduction of calcium levels, the patient underwent surgery with exeresis of the parathyroid mass proved an adenoma and normalization of calcium levels; nevertheless a few days after discharge symptomatic hypocalcemia occurred and was successfully managed by means of calcium and vitamin D therapy which is still required three months after surgery.

摘要

原发性甲状旁腺功能亢进是一种常见的内分泌病,如今多为偶然诊断。血钙水平从“正常”到极高不等,极高的血钙水平可能危及生命。我们报告一例女性患者,因非特异性症状入院,最终发现是由一个大的甲状旁腺肿瘤继发严重高钙血症所致。经过强化药物治疗(补液、利尿剂、类固醇、双膦酸盐)使血钙水平降低后,患者接受了手术,切除甲状旁腺肿物,病理证实为腺瘤,血钙水平恢复正常;然而,出院几天后出现了症状性低钙血症,通过钙剂和维生素D治疗成功得到控制,术后三个月仍需这种治疗。

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