Burch W M, Posillico J T
J Clin Endocrinol Metab. 1983 Aug;57(2):398-401. doi: 10.1210/jcem-57-2-398.
A 22-year-old woman developed hypoparathyroidism in 1970, 10 months after treatment of hyperthyroidism with I-131. The hypocalcemia was corrected with Vitamin D2 and oral calcium and she remained normocalcemic for 8 yr. In 1979 hypercalcemia was found and Vitamin D2/calcium was discontinued. Because she remained normocalcemic without therapy for 3 yr, we measured the levels of immunoreactive and bioactive PTH in plasma stored since 1970 and in plasma obtained in 1982 to determine whether there had been restoration of parathyroid function. Indeed, PTH levels in 1970 while the patient was hypocalcemic were low. The bioactive PTH was 0.26 pg/ml (normal 1.5-30), whereas--COOH terminal immunoreactive PTH was 620 pg/ml (normal 600-1500) and midmolecule immunoreactive PTH was 433 pg/ml (normal 300-900). In 1982 while normocalcemic the bioactive PTH and immunoreactive PTH were normal (5.18 pg/ml;--COOH, 970 pg/ml; midmolecule, 789 pg/ml, respectively). Thus, an unusual case of hypoparathyroidism after I-131 therapy with return of parathyroid function is documented by measurements of both immunoreactive and bioactive PTH.
一名22岁女性于1970年在接受I - 131治疗甲亢10个月后发生甲状旁腺功能减退。低钙血症通过维生素D2和口服钙剂得到纠正，她维持血钙正常8年。1979年发现高钙血症，停用维生素D2/钙剂。由于她未经治疗血钙正常维持了3年，我们检测了自1970年储存的血浆以及1982年采集的血浆中免疫反应性和生物活性甲状旁腺激素（PTH）水平，以确定甲状旁腺功能是否恢复。实际上，1970年患者低钙血症时PTH水平较低。生物活性PTH为0.26 pg/ml（正常为1.5 - 30），而羧基末端免疫反应性PTH为620 pg/ml（正常为600 - 1500），中分子免疫反应性PTH为433 pg/ml（正常为300 - 900）。1982年血钙正常时，生物活性PTH和免疫反应性PTH均正常（分别为5.18 pg/ml；羧基末端，970 pg/ml；中分子，789 pg/ml）。因此，通过免疫反应性和生物活性PTH的检测记录了1例I - 131治疗后甲状旁腺功能减退且甲状旁腺功能恢复的罕见病例。
