Perloff L J, Spence R K, Grossman R A, Barker C F
Transplantation. 1979 Jan;27(1):21-5. doi: 10.1097/00007890-197901000-00006.
The case studies of four patients with post-transplantation calcinosis are presented. Three of the four patients died of inanition and sepsis secondary to infection of extensive soft tissue ulcers and diffuse cutaneous vascular calcification with gangrene. The fourth patient survived following removal of all four parathyroid glands and autografting of approximately one-half of one gland. Common to the patients was secondary hyperparathyroidism, elevated mean serum calcium levels after transplantation, and radiographic evidence of small and medium vessel calcification. No other differences could be found between these patients and other patients with post-transplantation hyperparathyroidism without calcinosis. In the face of apparently minor complaints of lower extremity discomfort, elevated parathyroid hormone levels (PTH) and positive xerography may indicate subtotal parathyroidectomy regardless of the serum calcium level.
本文介绍了4例移植后钙质沉着症患者的病例研究。4例患者中有3例死于因广泛软组织溃疡感染及坏疽性弥漫性皮肤血管钙化继发的营养不良和败血症。第4例患者在切除所有4个甲状旁腺并自体移植约半个腺体后存活。这些患者的共同特点是继发性甲状旁腺功能亢进、移植后平均血清钙水平升高以及中小血管钙化的影像学证据。在这些患者与其他无钙质沉着症的移植后甲状旁腺功能亢进患者之间未发现其他差异。面对下肢不适的轻微主诉，甲状旁腺激素水平（PTH）升高及X线摄影阳性可能提示无论血清钙水平如何均应进行甲状旁腺次全切除术。
