Maschio G, Vecchioni R, Tessitore N
Am J Med. 1980 Oct;69(4):607-9. doi: 10.1016/0002-9343(80)90475-1.
In a woman with bilateral recurrent calcium nephrolithiasis and hypercalciuria, hypercalcemia developed and she underwent parathyroid surgery, which led to excision of a histologically-confirmed adenoma. The patient became normocalcemic but remained hypercalciuric despite reduction of dietary calcium intake. Several calculi recurred in both kidneys. Four to six years after parathyroidectomy, hypercalcemia recurred and the patient underwent a new surgical exploration; a parathyroid gland with diffuse adenomatous aspects and another gland with pure hyperplasia were excised. Once again, after surgery the patient became normocalcemic but remained hypercalciuric. Evidence for a "renal calcium leak" hypercalciuria was obtained, and thiazide administration led to normalization of urinary calcium excretion. In calcium nephrolithiasis, persistent hypercalciuria may lead to recurrence of autonomous hyperparathyroidism.
一名患有双侧复发性钙肾结石和高钙尿症的女性出现了高钙血症，随后接受了甲状旁腺手术，术中切除了组织学确诊的腺瘤。患者血钙恢复正常，但尽管减少了饮食中的钙摄入量，仍存在高钙尿症。双侧肾脏又复发了几颗结石。甲状旁腺切除术后四至六年，高钙血症再次出现，患者接受了新的手术探查；切除了一个具有弥漫性腺瘤样外观的甲状旁腺和另一个单纯增生的腺体。术后患者血钙再次恢复正常，但仍存在高钙尿症。有证据表明存在“肾钙漏”性高钙尿症，噻嗪类药物治疗使尿钙排泄恢复正常。在钙肾结石患者中，持续性高钙尿症可能导致自主性甲状旁腺功能亢进复发。
