Carey D E, Raisz L G
Arch Phys Med Rehabil. 1985 Sep;66(9):640-4.
During the course of hospitalization for comprehensive rehabilitation, an 11-year-old boy with a C4-C5 spinal cord injury developed hypercalcemia which persisted for 131 days. The total serum calcium was closely monitored during six treatment periods during which calcitonin was administered. The response to calcitonin was variable and limited by the occurrence of the escape phenomenon. Glucocorticoids were also partly effective but other antihypercalcemic therapies including low calcium diet, diuretics, IV saline, wheelchair sitting, and oral phosphates were not. A review of the pathophysiology of immobilization hypercalcemia indicates that increased bone resorption is primarily responsible for the disorder. Both calcitonin and glucocorticoids are potent inhibitors of bone resorption, and glucocorticoids can prevent escape from calcitonin's calcium-lowering effect. We suggest that combination therapy with calcitonin and glucocorticoids be utilized in severe hypercalcemia in order to take advantage of the rapid effect of calcitonin and the more sustained effect of glucocorticoids.
在进行综合康复治疗的住院期间，一名患有C4 - C5脊髓损伤的11岁男孩出现了持续131天的高钙血症。在六个使用降钙素的治疗阶段对血清总钙进行了密切监测。降钙素的反应存在差异，且受逃逸现象的限制。糖皮质激素也有部分疗效，但包括低钙饮食、利尿剂、静脉生理盐水、轮椅坐姿和口服磷酸盐在内的其他降钙治疗方法均无效。对制动性高钙血症病理生理学的回顾表明，骨吸收增加是该病症的主要原因。降钙素和糖皮质激素都是骨吸收的有效抑制剂，且糖皮质激素可防止降钙素降钙作用的逃逸。我们建议在严重高钙血症中采用降钙素和糖皮质激素联合治疗，以利用降钙素的快速起效作用和糖皮质激素更持久的作用。
