Kobayashi T, Baba M, Tanaka N, Takeda T, Shiba E, Takai S, Mori T
Department of Surgery II, Osaka University Medicine School, Japan.
Nihon Geka Gakkai Zasshi. 1993 Oct;94(10):1125-30.
We have treated 30 patients with hypercalcemia from 1984 to 1991. Twenty four out of 30 patients were associated with primary hyperparathyroidism and the other six were associated with malignancy. Of 24 cases primary hyperparathyroidism, 15 were due to single parathyroid adenoma, five to MEN 1 and one to familial hyperparathyroidism. In the other three cases, it was difficult to identify the cause of the hyperparathyroidism. Following conclusions were obtained: 1. Hypercalcemia shows no specific and characteristic symptoms, so it is essential to keep hypercalcemia in mind in diagnosis of patients with vague or general complaints. Malignancy associated hypercalcemia shows high serum calcium level and PTH level. When considering malignancy, it is easy to diagnose that it might be the cause of hypercalcemia. 2. When serum PTH is over 2000pg/ml (high sensitivity PTH assay) in primary hyperparathyroidism, the probability of swelling of multiple parathyroid glands should be considered in evaluation of localization study and surgery. When serum PTH is high or swelling of multiple glands is found. It is essential to evaluate the possibility of MEN 1.
1984年至1991年期间，我们共治疗了30例高钙血症患者。30例患者中，24例与原发性甲状旁腺功能亢进有关，另外6例与恶性肿瘤有关。在24例原发性甲状旁腺功能亢进病例中，15例是由单个甲状旁腺腺瘤引起，5例是由多发性内分泌腺瘤病1型（MEN 1）引起，1例是由家族性甲状旁腺功能亢进引起。在另外3例中，很难确定甲状旁腺功能亢进的病因。得出以下结论：1. 高钙血症没有特异性和特征性症状，因此在诊断有模糊或一般主诉的患者时，必须考虑到高钙血症。与恶性肿瘤相关的高钙血症表现为血清钙水平和甲状旁腺激素（PTH）水平升高。在考虑恶性肿瘤时，很容易诊断其可能是高钙血症的病因。2. 在原发性甲状旁腺功能亢进中，当血清PTH超过2000pg/ml（高灵敏度PTH检测）时，在评估定位研究和手术时应考虑多个甲状旁腺肿大的可能性。当血清PTH升高或发现多个腺体肿大时，必须评估MEN 1的可能性。
