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甲状旁腺功能亢进危象致高钙血症相关性急性心脏损害和急性肾损伤 1 例报告

Acute cardiac damage and acute kidney injury associated with hypercalcemia crisis in hyperparathyroidism: a case report.

机构信息

Department of Thyroid and Breast Surgery, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China.

出版信息

J Int Med Res. 2021 Oct;49(10):3000605211050614. doi: 10.1177/03000605211050614.

Abstract

Hyperparathyroidism-induced hypercalcemic crisis is a rare presentation of primary hyperparathyroidism. Primary hyperparathyroidism is caused by uncontrolled and immoderate secretion of parathyroid hormone. The most common presentation in primary hyperparathyroidism is renal stones, soft tissue calcification, cystic bone disease, and even hypercalcemic crisis. We report a patient who presented with multiple organ dysfunction syndrome due to extreme hypercalcemia (serum calcium concentration, 4.79 mmol/L [2.15-2.25 mmol/L]) resulting from primary hyperparathyroidism (serum parathyroid hormone concentration, 2215 pg/mL). The complications in this patient were complete cardiac damage and acute kidney injury. On the basis of the hypercalcemic crisis, the patient subsequently underwent surgical resection of parathyroid adenoma. Two days after surgery, her serum calcium and parathyroid hormone concentrations were normal. The patient had a good recovery after a series of other relevant therapies. In conclusion, surgery should be taken into consideration for hyperparathyroidism.

摘要

甲状旁腺功能亢进症引起的高钙血症危象是甲状旁腺功能亢进症的一种罕见表现。甲状旁腺功能亢进症是由甲状旁腺激素不受控制和过度分泌引起的。甲状旁腺功能亢进症最常见的表现是肾结石、软组织钙化、囊性骨病,甚至高钙血症危象。我们报告了一例因原发性甲状旁腺功能亢进症导致极度高钙血症(血清钙浓度 4.79mmol/L[2.15-2.25mmol/L])引起多器官功能障碍综合征的患者,其血清甲状旁腺激素浓度为 2215pg/mL。该患者的并发症为完全性心肌损伤和急性肾损伤。基于高钙血症危象,该患者随后接受了甲状旁腺腺瘤切除术。术后 2 天,其血清钙和甲状旁腺激素浓度恢复正常。患者在接受了一系列其他相关治疗后恢复良好。总之,应考虑手术治疗甲状旁腺功能亢进症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27fe/8544773/bd860be85245/10.1177_03000605211050614-fig1.jpg

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