年轻女性以多发性骨骼破坏为表现的症状性原发性甲状旁腺功能亢进症：病例报告及文献复习。
Symptomatic primary hyperparathyroidism in a young woman presenting with multiple skeletal destructions: a case report and review of literature.
机构信息
Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, 100035, China.
Department of General Surgery, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China.
出版信息
BMC Endocr Disord. 2021 Jan 7;21(1):5. doi: 10.1186/s12902-020-00669-3.
BACKGROUND
Multiple pathological manifestations are rarely present in patients with primary hyperparathyroidism (PHPT). Here we described a case of a young woman who presented with multiple skeletal destructions and received an unclear diagnosis at several hospitals.
CASE PRESENTATION
A 30-year-old woman was admitted to our hospital due to pain in both knees and walking difficulty that lasted for 6 and 2 years, respectively. Her laboratory test results revealed a high parathyroid hormone level (822 pg/ml) and hypercalcemia (2.52 mmol/L) in the blood. Parathyroid imaging revealed a lumpy concentration of radioactive uptake detected at the lower pole in the right lobe of the thyroid, and was nearly 2.2 cm * 2.4 cm in size. Next, the patient was treated with parathyroidectomy that resulted in a significant improvement in physiological and clinical symptoms. Moreover, the skeletal destruction and bone mineral density were significantly improved after a 5-years follow-up period.
CONCLUSIONS
Multiple skeletal destructions can be caused by PHPT that should be taken into consideration in young patients with complex bone lesions.
背景
原发性甲状旁腺功能亢进症（PHPT）患者很少出现多种病理表现。在这里，我们描述了一例年轻女性，她表现为多处骨骼破坏，在几家医院的诊断均不明确。
病例介绍
一名 30 岁女性因双膝疼痛和行走困难分别持续 6 年和 2 年而被收入我院。实验室检查结果显示甲状旁腺激素水平（822 pg/ml）升高，血钙（2.52 mmol/L）升高。甲状旁腺影像学检查显示甲状腺右叶下极有放射性摄取肿块，大小约为 2.2cm*2.4cm。随后，患者接受了甲状旁腺切除术，术后生理和临床症状显著改善。此外，经过 5 年的随访，骨骼破坏和骨密度明显改善。
结论
多种骨骼破坏可由 PHPT 引起，对于有复杂骨骼病变的年轻患者应考虑到这一点。
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