Minaire P, Meunier P, Berard E, Girard R, Bourret J
Nouv Presse Med. 1977 Dec 3;6(41):3843-6.
Hypercalcaemia would seem to be rare during immobilisation, whilst osteoporosis and hypercalciuria are constant. In fact, it often goes unnoticed. The case presented here confirms its predominance in the adolescent male. The reason for immobilisation seems to be irrelevant. The clinical symptoms are very variable: polydipsia, nausea, headache, apathy, anorexia. Blood calcium levels are raised, up to 14 mg%. This hypercalcaemia is due to very marked bone loss in adolescents, secondary to hyper-resorption and a temporary stoppage in osseous formation. The differential diagnosis from primary hyperparathyroidism is sometimes difficult but is aided by laboratory and histological findings. The essential is to consider the possibility of immobilisation hypercalcaemia in the presence of any suggestive symptoms in an immobilised adolescent. Treatment includes a return to weight bearing, adequate water intake and the administration of phosphorus, calcitonin, furosemide, and corticosteroids.
在制动期间高钙血症似乎很少见,而骨质疏松症和高钙尿症则很常见。事实上,它常常未被注意到。本文介绍的病例证实了其在青少年男性中的优势。制动的原因似乎并不重要。临床症状变化很大:烦渴、恶心、头痛、冷漠、厌食。血钙水平升高,可达14mg%。这种高钙血症是由于青少年骨量明显丢失,继发于骨吸收增加和骨形成暂时停止。与原发性甲状旁腺功能亢进症的鉴别诊断有时很困难,但实验室和组织学检查结果有助于诊断。关键是在制动的青少年出现任何提示性症状时,要考虑到制动性高钙血症的可能性。治疗包括恢复负重、充足的水分摄入以及给予磷、降钙素、呋塞米和皮质类固醇。