Fukasawa Hirotaka, Ide Saki, Kaneko Mai, Ishibuchi Kento, Niwa Hiroki, Yasuda Hideo, Furuya Ryuichi
Renal Division, Department of Internal Medicine, Iwata City Hospital, Japan.
First Department of Medicine, Hamamatsu University School of Medicine, Japan.
Intern Med. 2019 Jun 1;58(11):1583-1586. doi: 10.2169/internalmedicine.2115-18. Epub 2019 Feb 1.
Hypercalcemia is a severe complication in cases of vitamin D intoxication that can result in metastatic calcification. We herein report a female case with hypercalcemia due to eldecalcitol administration associated with the increased uptake of technetium-99m hydroxymethylene diphosphonate (Tc-HMDP) as the bone-scanning agent in the stomach. A histologic assessment using biopsy specimens identified metastatic calcification of the stomach. After the normalization of serum calcium levels, the gastric uptake of Tc-HMDP disappeared. This case indicates the usefulness of bone scintigraphy with Tc-HMDP to detect visceral metastatic calcification and to monitor its therapeutic effects in patients with hypercalcemia.
高钙血症是维生素D中毒病例中的一种严重并发症,可导致转移性钙化。我们在此报告一例女性病例,该患者因服用依地骨化醇导致高钙血症,同时胃内作为骨扫描剂的锝-99m亚甲基二膦酸盐(Tc-HMDP)摄取增加。使用活检标本进行的组织学评估确定胃有转移性钙化。血清钙水平恢复正常后,胃对Tc-HMDP的摄取消失。该病例表明,使用Tc-HMDP进行骨闪烁显像对于检测高钙血症患者的内脏转移性钙化及其治疗效果监测具有实用性。