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1例患有先天性纯红细胞再生障碍性贫血的患者并发甲状旁腺功能减退和黏液性水肿昏迷的罕见病例。

A Rare Case of Hypoparathyroidism and Myxedema Coma in a Patient With Diamond-Blackfan Anemia.

作者信息

Ruggiero Raffaele A, Iqbal Qasim Z, Akram Ali, Dendy Jared, Zaidan Julie

机构信息

Internal Medicine, Northwell Health, New York, USA.

Internal Medicine, Ochsner Clinic Foundation, New Orleans, USA.

出版信息

Cureus. 2021 Nov 27;13(11):e19941. doi: 10.7759/cureus.19941. eCollection 2021 Nov.

Abstract

Diamond-Blackfan anemia (DBA) is a rare genetic condition that presents due to bone marrow failure caused by a dysfunction in ribosomal biogenesis and function. The patients would often require chronic transfusions as treatment, which puts them at high risk for the development of secondary hemochromatosis. This secondary hemochromatosis results in endocrinopathies due to iron deposition into the endocrine glands. We present an interesting case report of a female patient with multiple endocrinopathies due to secondary hemochromatosis resulting from chronic transfusion therapy. Her endocrinopathies included hypothyroidism complicated by myxedema coma and, interestingly, hypoparathyroidism, which has seldom been reported in DBA patients. Early diagnosis and precise treatment of life-threatening conditions like myxedema coma in DBA patients can avoid morbidity and mortality.

摘要

钻石黑范贫血(DBA)是一种罕见的遗传性疾病,由于核糖体生物合成和功能障碍导致骨髓衰竭而出现。患者通常需要长期输血作为治疗手段,这使他们面临继发性血色素沉着症的高风险。这种继发性血色素沉着症由于铁沉积在内分泌腺中而导致内分泌病。我们报告了一例有趣的病例,一名女性患者因慢性输血治疗导致继发性血色素沉着症,出现了多种内分泌病。她的内分泌病包括并发黏液性水肿昏迷的甲状腺功能减退症,有趣的是,还有甲状旁腺功能减退症,这在DBA患者中很少有报道。对DBA患者中像黏液性水肿昏迷这样危及生命的疾病进行早期诊断和精确治疗,可以避免发病和死亡。

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Presentation of Hypoparathyroidism: Etiologies and Clinical Features.甲状旁腺功能减退症的表现:病因和临床特征。
J Clin Endocrinol Metab. 2016 Jun;101(6):2300-12. doi: 10.1210/jc.2015-3909. Epub 2016 Mar 4.
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Thyroid emergencies.甲状腺危象。
Med Clin North Am. 2012 Mar;96(2):385-403. doi: 10.1016/j.mcna.2012.01.015. Epub 2012 Feb 17.
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