Mashayekhi Yashar, Baba-Aissa Sara, Al-Qaysi Amina, Eish Mohammed, Timamy Abdulmalik, Panourgia Maria, Ahmed Mohamed H
Faculty of Medicine and Health Sciences, The University of Buckingham, Buckingham, UK.
Department of Diabetes and Endocrinology, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK.
J Med Cases. 2024 Aug;15(8):180-185. doi: 10.14740/jmc4235. Epub 2024 Jul 18.
Two patients aged 82 and 77, with a fractured neck of the femur, were found to have primary hyperparathyroidism, characterized by hypercalcemia and hypercalciuria. Post-surgery, both developed pulmonary embolism (PE), highlighting a possible link between hypercalcemia and increased hypercoagulation risk. There have been few case reports suggesting the association between hypercalcemia due to hyperparathyroidism and the increase in tendency of hypercoagulation and subsequent risk of venous thromboembolism (VTE). This case series offers insights into how ionized calcium influences thrombin formation, platelet activation and aggregation, and activation of clotting factors such as factor VII and factor X, raising questions about the role of chronic hypercalcemia in VTE. Further research is needed to 1) establish whether chronic hypercalcemia in the absence of fracture can modulate the risk of hypercoagulation; 2) determine whether chronic hypercalcemia in individuals with bone fracture may represent a significantly higher hypercoagulability risk during the postoperative periods.
两名分别为82岁和77岁的股骨颈骨折患者被发现患有原发性甲状旁腺功能亢进,其特征为高钙血症和高钙尿症。术后,两人均发生了肺栓塞(PE),这凸显了高钙血症与高凝风险增加之间可能存在的联系。很少有病例报告提示甲状旁腺功能亢进所致高钙血症与高凝倾向增加及随后的静脉血栓栓塞(VTE)风险之间存在关联。本病例系列深入探讨了离子钙如何影响凝血酶形成、血小板活化和聚集,以及凝血因子如因子VII和因子X的活化,引发了关于慢性高钙血症在VTE中作用的疑问。需要进一步研究以:1)确定在无骨折情况下慢性高钙血症是否可调节高凝风险;2)确定骨折患者中的慢性高钙血症在术后期间是否可能代表显著更高的高凝风险。
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