Goyal Alpesh, Agarwal Shipra, Goswami Ravinder, Bal Chandrasekhar
Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Department of Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
BMJ Case Rep. 2020 Nov 9;13(11):e237261. doi: 10.1136/bcr-2020-237261.
Serum intact parathyroid hormone (iPTH) levels are high or high normal in patients with parathyroid adenoma. Rarely these patients can have normal or low serum iPTH values. With sandwich immunometric assays, an exceptionally high serum iPTH level can lead to falsely low measurement due to the 'hook effect'. Here, we describe the case of a 66-year-old female patient with PTH-independent hypercalcaemia which mimicked parathyroid adenoma. A multidisciplinary team approach helped in the diagnosis and management leading to complete recovery.
甲状旁腺腺瘤患者的血清完整甲状旁腺激素(iPTH)水平较高或处于高正常范围。这些患者很少会出现血清iPTH值正常或偏低的情况。使用夹心免疫测定法时,血清iPTH水平异常高可能会因“钩状效应”导致测量值假性偏低。在此,我们描述了一例66岁女性患者,其患有与甲状旁腺激素无关的高钙血症,临床表现类似甲状旁腺腺瘤。多学科团队协作有助于诊断和管理,最终患者完全康复。