Vogelgesang S A, McMillin J M
Research Service, Sioux Falls Veterans Administration Hospital, South Dakota.
J Urol. 1988 Nov;140(5):1025-7. doi: 10.1016/s0022-5347(17)41918-5.
We report 2 cases of true hypocalcemia (not caused by decreased binding proteins) associated with metastatic prostate cancer and review previously reported cases. Hypocalcemia is a common but frequently unrecognized complication of prostatic cancer. Estrogen therapy often is associated with the hypocalcemia, which may be asymptomatic. The hypocalcemia is always associated with osteoblastic metastases and usually it is associated with increased serum alkaline phosphatase activity, acid phosphatase activity and serum parathyroid hormone concentration. Serum concentrations of magnesium, phosphorus and vitamin D frequently are decreased. Patients are in a positive calcium balance. The osteoblastic metastases seem to act as a calcium sink, creating a "hungry tumor phenomenon". The role of estrogens may be to stop the resorption of normal bone resulting in lower serum calcium concentrations.
我们报告2例与转移性前列腺癌相关的真性低钙血症（并非由结合蛋白减少所致），并回顾先前报道的病例。低钙血症是前列腺癌常见但常未被认识到的并发症。雌激素治疗常与低钙血症相关，且可能无症状。低钙血症总是与成骨性转移相关，通常还与血清碱性磷酸酶活性、酸性磷酸酶活性及血清甲状旁腺激素浓度升高有关。血清镁、磷和维生素D浓度常降低。患者处于钙正平衡状态。成骨性转移似乎起到钙库的作用，产生“饥饿肿瘤现象”。雌激素的作用可能是阻止正常骨的吸收，导致血清钙浓度降低。
