Jiangsu University Affiliated Hospital Thyroid and Breast Surgery Department, Zhenjiang, China.
BMC Endocr Disord. 2024 Sep 30;24(1):208. doi: 10.1186/s12902-024-01742-x.
Parathyroid adenoma is the primary cause of primary hyperparathyroidism, commonly presenting with elevated parathyroid hormone (PTH) and blood calcium levels. Chronic primary hyperparathyroidism often results in bone destruction, resulting in the formation of brown tumors. The preferred clinical treatment for parathyroid adenoma is parathyroidectomy. Postoperative pancytopenia, although rare, is a critical complication that warrants further investigation into its mechanisms and management strategies.
We present a case of a 59-year-old female patient who was admitted due to nausea and vomiting. Positron emission tomography-computed tomography (PET-CT) revealed a mass posterior to the left thyroid lobe and multiple areas of fibrocystic osteitis throughout the body. Hematological tests showed elevated serum calcium and parathyroid hormone (PTH) levels. The patient subsequently underwent parathyroidectomy, and pathological examination confirmed the presence of a parathyroid adenoma. Postoperatively, the patient developed pancytopenia and received symptomatic treatment such as correction of anemia and elevation of white blood. At the two-month follow-up, all indicators had returned to normal.
Pancytopenia is commonly seen in bone marrow diseases, infections and immune-related disorders, nutritional deficiencies, and metabolic diseases. This case confirms that pancytopenia can also occur postoperatively in patients with parathyroid adenoma. Therefore, Clinicians should be aware of the potential for postoperative pancytopenia following parathyroidectomy and the need for prompt management.
甲状旁腺腺瘤是原发性甲状旁腺功能亢进症的主要病因，常表现为甲状旁腺激素（PTH）和血钙水平升高。慢性原发性甲状旁腺功能亢进症常导致骨破坏，形成棕色瘤。甲状旁腺腺瘤的首选临床治疗方法是甲状旁腺切除术。术后全血细胞减少症虽然罕见，但却是一种严重的并发症，需要进一步研究其发病机制和治疗策略。
我们报告了一例 59 岁女性患者，因恶心和呕吐入院。正电子发射断层扫描-计算机断层扫描（PET-CT）显示左甲状腺叶后有一个肿块和全身多处纤维囊性骨炎。血液学检查显示血清钙和甲状旁腺激素（PTH）水平升高。随后患者接受了甲状旁腺切除术，病理检查证实存在甲状旁腺腺瘤。术后患者出现全血细胞减少症，并接受了对症治疗，如贫血纠正和白细胞升高。在两个月的随访中，所有指标均恢复正常。
全血细胞减少症常见于骨髓疾病、感染和免疫相关疾病、营养缺乏症和代谢性疾病。本病例证实，甲状旁腺腺瘤患者术后也可能发生全血细胞减少症。因此，临床医生应意识到甲状旁腺切除术后发生全血细胞减少症的可能性，并需要及时进行管理。
