Maynard F M, Imai K
Arch Phys Med Rehabil. 1977 Jan;58(1):16-24.
Four patients having high-level quadriplegia developed elevated serum calcium concentrations (11 to 15.8 mg/100 ml) within three months of injury. All were young males (ages 15 to 19 years) and quadriplegic (C4-C7). Presenting symptoms were nausea, vomiting, polydipsia, polyuria and lethargy. In two patients severe muscle wasting and cachexia with clinical symptoms developed and persisted for several months. Laboratory studies in all patients showed negative calcium balance with hypercalciuria. Reduced renal function was seen in all patients but returned to normal with return of normal serum calcium. Alkaline phosphatase level was normal in three and elevated in one. Serum parathormone levels were normal. Roentgenograms revealed diffuse demineralization. Nephrocalcinosis and soft tissue calcifications developed in one patient. Primary treatment included reduced calcium intake, correction of dehydration, sodium infusion and remobilization. Corticosteroids, oral phosphates, furosemide and mithramycin were used with varying success to control prologned symptoms and severe hypercalcemia.
4例高位截瘫患者在受伤后3个月内血清钙浓度升高（11至15.8mg/100ml）。所有患者均为年轻男性（年龄15至19岁），且为四肢瘫痪（C4 - C7）。主要症状为恶心、呕吐、烦渴、多尿和嗜睡。2例患者出现严重肌肉萎缩和恶病质，并伴有临床症状，持续数月。所有患者的实验室检查均显示钙平衡为负，伴有高钙尿症。所有患者均出现肾功能减退，但随着血清钙恢复正常，肾功能也恢复正常。3例患者碱性磷酸酶水平正常，1例升高。血清甲状旁腺激素水平正常。X线片显示弥漫性骨质脱钙。1例患者出现肾钙质沉着症和软组织钙化。主要治疗措施包括减少钙摄入、纠正脱水、输注钠和活动。使用皮质类固醇、口服磷酸盐、呋塞米和光辉霉素控制持续症状和严重高钙血症，效果各异。
