Olmer M, Berland Y, Argemi B
Kidney Int Suppl. 1983 Dec;16:S175-9.
We examined parathyroid gland function in 47 patients with idiopathic hypercalciuria in an effort to determine whether serum levels of parathyroid hormone (PTH) and/or urinary excretion of cyclic adenosine monophosphate (cyclic AMP) can discriminate between the various forms of hypercalciuria. Although we could separate our 47 patients into two groups, 21 patients with renal hypercalciuria (RH) and 15 patients with absorptive hypercalciuria (AH), there remained a group of 11 patients who did not exactly correspond to either group. Basal serum PTH was normal in the two groups: for RH, 10.32 +/- 0.93; for AH, 11.43 +/- 1.10 microliter Eq/ml. Similarly, urinary cyclic AMP did not differ between the two groups: for RH, 4.88 +/- 0.5; for AH, 4.87 +/- 0.55 nmoles/dl/min GFR. Moreover, the response of the parathyroid glands to acute hypocalcemia produced by intravenous infusion of EDTA was not different among patients with AH, RH, and control subjects. Only one patient showed a marked increase of serum PTH in response to acute hypocalcemia, and the bone biopsy revealed increased osteoclastic resorption. In conclusion, our data show that serum levels of PTH and urinary cyclic AMP do not differentiate between the various forms of idiopathic hypercalciuria. The EDTA test demonstrated that secondary hyperparathyroidism is very uncommon in these patients.
我们对47例特发性高钙尿症患者的甲状旁腺功能进行了检查，以确定血清甲状旁腺激素（PTH）水平和/或尿中环磷酸腺苷（环磷腺苷）排泄量是否能够区分不同类型的高钙尿症。尽管我们可以将47例患者分为两组，即21例肾性高钙尿症（RH）患者和15例吸收性高钙尿症（AH）患者，但仍有11例患者不完全符合这两组中的任何一组。两组患者的基础血清PTH均正常：RH组为10.32±0.93；AH组为11.43±1.10微升当量/毫升。同样，两组患者的尿环磷腺苷也无差异：RH组为4.88±0.5；AH组为4.87±0.55纳摩尔/分升/分钟肾小球滤过率。此外，AH患者、RH患者和对照受试者对静脉输注EDTA引起的急性低钙血症的甲状旁腺反应无差异。只有1例患者对急性低钙血症反应时血清PTH显著升高，骨活检显示破骨细胞吸收增加。总之，我们的数据表明，PTH血清水平和尿环磷腺苷不能区分不同类型的特发性高钙尿症。EDTA试验表明，这些患者中继发性甲状旁腺功能亢进非常少见。
