Zhang Wei, Xue Feng, Bu Quandong, Liu Xuemei
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
J Int Med Res. 2020 Jul;48(7):300060520942115. doi: 10.1177/0300060520942115.
Hypocalcemia is a rare, but reversible, cause of dilated cardiomyopathy. Although cardiomyopathy may cause severe heart failure, calcium supplementation can reverse heart failure. We report here a patient with uremia and secondary hyperparathyroidism, who was complicated by persistent hypocalcemia and refractory heart failure. The cardiac failure was refractory to treatment with digitalis and diuretics, but dramatically responded to calcium therapy and restoration of normocalcemia. As a result, the patient was eventually diagnosed with hypocalcemic cardiomyopathy. To the best of our knowledge, this is the first case of this disease to be reported in a patient with uremia. Findings from our case may help clinicians to better understand hypocalcemic cardiomyopathy. Our case might also provide new insight into long-term cardiac complications and prognoses of patients undergoing parathyroidectomy due to secondary hyperparathyroidism.
低钙血症是扩张型心肌病一种罕见但可逆转的病因。尽管心肌病可能导致严重心力衰竭，但补充钙可以逆转心力衰竭。我们在此报告一名患有尿毒症和继发性甲状旁腺功能亢进的患者，该患者并发持续性低钙血症和难治性心力衰竭。心力衰竭对洋地黄和利尿剂治疗无效，但对钙治疗和恢复正常血钙水平有显著反应。结果，该患者最终被诊断为低钙血症性心肌病。据我们所知，这是首例在尿毒症患者中报告的该疾病病例。我们病例的发现可能有助于临床医生更好地理解低钙血症性心肌病。我们的病例也可能为因继发性甲状旁腺功能亢进接受甲状旁腺切除术患者的长期心脏并发症和预后提供新的见解。
