Wilczek H, Kanka J
3rd Medical Clinic, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
Sb Lek. 1993;94(3):213-7.
The coincidence or association of some metabolic bone diseases is known although it occurs rarely. The authors present a very rare association of Paget's bone disease with primary hyperparathyroidism in a 65 year old male with overt Paget's disease of bone since 1985. For during five years the patient was treated symptomatically only. Later he developed a biochemical syndrome suspect from primary hyperparathyroidism with signs of preexisting Paget's disease of bone. The diagnostic and therapeutic approach is presented. After the removal of parathyroid adenoma, laboratory findings depicted recent status of Paget's disease of bone with high activity. Treatment of this disorder was advised and begun. The overproduction of parathyroid hormone in Paget's disease of bone is not usual and the mechanism of overproduction remains often unclear. Some views from literature are presented and discussed. If the parameters of bone metabolism cause doubt about the origin of the bone disease and a possibility of some combination occurs, it must be born in mind that such combinations may exist.
一些代谢性骨病的巧合或关联虽罕见但已为人所知。作者报告了一例非常罕见的病例，一名65岁男性自1985年起患有明显的佩吉特骨病，同时合并原发性甲状旁腺功能亢进。在五年时间里，该患者仅接受了对症治疗。后来，他出现了疑似原发性甲状旁腺功能亢进的生化综合征，同时伴有先前存在的佩吉特骨病迹象。文中介绍了诊断和治疗方法。切除甲状旁腺腺瘤后，实验室检查结果显示佩吉特骨病近期处于高活动状态。建议并开始了针对该疾病的治疗。骨佩吉特病中甲状旁腺激素分泌过多并不常见，其分泌过多的机制通常仍不清楚。文中呈现并讨论了文献中的一些观点。如果骨代谢参数对骨病的起源产生怀疑，并且存在某种合并症的可能性，那么必须记住可能存在此类合并症。
