一例甲状旁腺功能亢进症患者行甲状旁腺切除术后出现持续性肾性尿崩症的病例。

A case with persistent nephrogenic diabetes insipidus following parathyroidectomy for hyperparathyroidism.

作者信息

Nubiola A, Vendrell J, Cabrer J, Halperin I, Conget I, Vilardell E

机构信息

Servei d'Endocrinologia i Diabetis, Hospital Clinic i Provincial, Barcelona, Spain.

出版信息

J Endocrinol Invest. 1988 Dec;11(11):809-12. doi: 10.1007/BF03350231.

DOI:10.1007/BF03350231

PMID:3225402

Abstract

A 25-year-old woman with persistent nephrogenic diabetes insipidus (NDI) following parathyroidectomy for primary hyperparathyroidism is described. NDI is a well recognized complication of primary hyperparathyroidism, generally imputed to hypercalcemia, and promptly reversible after correcting it. In our case, the impaired concentrating ability of the renal tubule was irreversible after the removal of the parathyroid adenoma and the correction of the hypercalcemia, presumptively due to the morphological irreversible changes in the kidney. In addition, hypercalciuria persisted and was the cause of a compensatory hyperparathyroidism. Treatment with thiazide diuretic was effective to decrease relative hypercalciuria, thus reversing the compensatory hyperparathyroidism.

摘要

本文描述了一名25岁女性，因原发性甲状旁腺功能亢进接受甲状旁腺切除术后出现持续性肾性尿崩症（NDI）。NDI是原发性甲状旁腺功能亢进一种公认的并发症，通常归因于高钙血症，纠正后可迅速逆转。在我们的病例中，切除甲状旁腺腺瘤并纠正高钙血症后，肾小管浓缩功能受损是不可逆的，推测是由于肾脏形态学上的不可逆变化。此外，高钙尿症持续存在，是代偿性甲状旁腺功能亢进的原因。噻嗪类利尿剂治疗可有效降低相对高钙尿症，从而逆转代偿性甲状旁腺功能亢进。