外源性甲状腺功能亢进症伴骨质疏松症。

Exogenous hyperthyroidism with osteoporosis.

作者信息

Fallon M D, Perry H M, Bergfeld M, Droke D, Teitelbaum S L, Avioli L V

出版信息

Arch Intern Med. 1983 Mar;143(3):442-4.

Abstract

Symptomatic osteopenia accompanied by subclinical hyperthyroidism developed in three women who were receiving excess thyroid hormone medication. Excessive thyroid replacement therapy resulted in mild hypercalcemia, hyperphosphatemia, and hyperphosphatasemia associated with diffuse skeletal demineralization and multiple fractures. Nondecalcified sections of double tetracycline-labeled iliac crest bone showed an accelerated rate of bone turnover with marked osteoclastosis and resorption of the cortical as well as the trabecular bone, typical of endogenous hyperthyroidism. Since thyroid hormones are among the most frequently prescribed medications, bone loss caused by exogenous hyperthyroidism may be more common than previously recognized.

摘要

三名接受过量甲状腺激素药物治疗的女性出现了伴有亚临床甲状腺功能亢进的症状性骨质减少。过量的甲状腺替代治疗导致轻度高钙血症、高磷血症和高碱性磷酸酶血症，并伴有弥漫性骨质脱矿和多处骨折。双四环素标记的髂嵴骨的未脱钙切片显示骨转换率加快，伴有明显的破骨细胞增多以及皮质骨和小梁骨的吸收，这是内源性甲状腺功能亢进的典型表现。由于甲状腺激素是最常用的处方药之一，外源性甲状腺功能亢进引起的骨质流失可能比以前认为的更为常见。