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在一名因结核性淋巴结炎导致高钙血症的患者中，增生性甲状腺结节伪装成甲状旁腺腺瘤。

Hyperplastic thyroid nodule masquerading as parathyroid adenoma in a patient with tubercular lymphadenitis induced hypercalcaemia.

作者信息

Goyal Alpesh, Agarwal Shipra, Goswami Ravinder, Bal Chandrasekhar

机构信息

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

出版信息

BMJ Case Rep. 2020 Nov 9;13(11):e237261. doi: 10.1136/bcr-2020-237261.

DOI:10.1136/bcr-2020-237261
PMID:33168536
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7654110/
Abstract

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.

摘要

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。

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本文引用的文献

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The "hook effect" causing a negative pregnancy test in a patient with an advanced molar pregnancy.“钩状效应”导致一名患有晚期葡萄胎妊娠的患者妊娠试验呈阴性。
Gynecol Oncol Rep. 2017 Jun 7;21:34-36. doi: 10.1016/j.gore.2017.06.008. eCollection 2017 Aug.
3
Coexisting primary hyperparathyroidism and sarcoidosis cause increased angiotensin-converting enzyme and decreased parathyroid hormone and phosphate levels.共存的原发性甲状旁腺功能亢进症和结节病导致血管紧张素转换酶升高、甲状旁腺激素和磷酸盐水平降低。
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4
Thyroid diseases cause mismatch between MIBI scan and neck ultrasound in the diagnosis of hyperfunctioning parathyroids: usefulness of FNA-PTH assay.甲状腺疾病导致 MIBI 扫描与颈部超声在功能性甲状旁腺腺瘤诊断中的不匹配：FNA-PTH 测定的作用。
Eur J Endocrinol. 2012 Dec 10;168(1):49-58. doi: 10.1530/EJE-12-0742. Print 2013 Jan.
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The phenotype of primary hyperparathyroidism with normal parathyroid hormone levels: how low can parathyroid hormone go?甲状旁腺功能亢进症伴正常甲状旁腺激素水平的表型：甲状旁腺激素可以低到什么程度？
Surgery. 2011 Dec;150(6):1102-12. doi: 10.1016/j.surg.2011.09.011.
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