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[非肿瘤性高钙血症]

[Non-neoplastic hypercalcemia].

作者信息

Bernadet P, Tremollières F, Durand D, Ton That H, Suc J M

出版信息

Rev Prat. 1989 Apr 13;39(11):932-5.

PMID:2717864
Abstract

Hypercalcaemia is a frequent situation in clinical practice. An earlier detection is facilitated by routine analysis of serum calcium. The clinical manifestations depend on severity and the rate of onset of hypercalcaemia. Paucisymptomatic and asymptomatic presentations are the most frequent. Causes of hypercalcaemia are numerous and the mechanisms are various. PTH and vit. D play a preponderant part. In first of all iatrogenic cause are eliminated (all vit D preparations, thiazide diuretics, milk-alkali syndrome). Among non neoplastic hypercalcaemia primary hyperparathyroidism is the first diagnosis. Nephrolithiasis and asymptomatic forms are the most frequent presentations actually. The biochemical profile is not always typical. Generally the association of echography and tomodensitometry lead to the topographic diagnosis. Parathyroid surgical exploration is often necessary in difficult cases. Secondary, the other rare causes of hypercalcaemia are studied: sarcoidosis and granulomatosis disease, thyrotoxicosis and dome endocrinopathies, immobilisation hypercalcaemia, familial hypocalciuric, hypercalcaemia. All of this causes of hypercalcaemia are potentially reversible.

摘要

高钙血症在临床实践中很常见。血清钙的常规分析有助于早期发现。临床表现取决于高钙血症的严重程度和发病速度。症状轻微和无症状的表现最为常见。高钙血症的病因众多,机制各异。甲状旁腺激素(PTH)和维生素D起主要作用。首先要排除医源性原因(所有维生素D制剂、噻嗪类利尿剂、乳碱综合征)。在非肿瘤性高钙血症中,原发性甲状旁腺功能亢进是首要诊断。肾结石和无症状形式是目前最常见的表现。生化特征并不总是典型的。一般来说,超声检查和断层扫描相结合可得出定位诊断。在困难病例中,甲状旁腺手术探查往往是必要的。其次,要研究高钙血症的其他罕见原因:结节病和肉芽肿病、甲状腺毒症和其他内分泌病、制动性高钙血症、家族性低钙尿性高钙血症。所有这些高钙血症病因都可能是可逆的。

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