Yu J M, Pyo H J, Choi D S, Lee K W, Yoo K H, Kim C S
Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea.
J Korean Med Sci. 1994 Jun;9(3):268-72. doi: 10.3346/jkms.1994.9.3.268.
Primary hyperparathyroidism is a rare disease in children and is characterized by conspicuous skeletal and renal changes. A 12 year old male patient presented with symptoms of polydipsia, polyuria, general weakness, nausea, and vomiting which had begun 3 months earlier, and showed typical laboratory findings of primary hyperparathyroidism. Confirmatory diagnosis was made by elevated parathyroid hormone concentration in serum, technetium-thallium subtraction scan imaging method and histopathologic finding of chief cell hyperplasia. The laboratory findings revealed elevated levels of BUN, creatinine and decreased GFR. Kidney biopsy showed typical calcium deposits in tubules with marked tubulointerstitial infiltration. After subtotal parathyroidectomy, clinical findings improved remarkably.
原发性甲状旁腺功能亢进症在儿童中是一种罕见疾病,其特征为显著的骨骼和肾脏改变。一名12岁男性患者出现多饮、多尿、全身乏力、恶心和呕吐症状,这些症状始于3个月前,并表现出原发性甲状旁腺功能亢进症的典型实验室检查结果。通过血清甲状旁腺激素浓度升高、锝-铊减影扫描成像方法以及主细胞增生的组织病理学发现做出了确诊。实验室检查结果显示血尿素氮、肌酐水平升高,肾小球滤过率降低。肾脏活检显示肾小管中有典型的钙沉积,并伴有明显的肾小管间质浸润。次全甲状旁腺切除术后,临床症状显著改善。