Wasmuth H H, Verhage C C
Tidsskr Nor Laegeforen. 1993 Jun 20;113(16):1987-9.
After a near total small bowel resection for an acute thrombosis of the mesenterial artery, a 61 year-old man was treated with total parenteral nutrition at home for five years. The treatment was complicated by episodes of sepsis, anaemia and uremia. After four years he developed pain in long bones and the back and grave hypercalcuria. Roentgenogram showed demineralisation. There was no hyperparathyroidism and serum phosphate and serum calcium were normal. His chronic metabolic acidosis was treated continuously with enteral acetate. He received basal amounts of vitamin D and amino acids. By administering calcitonin we were able to cure his progressive bone pains and normalize his calcium urinary output. No side effects were observed. Therefore, calcitonin may contribute to the treatment of bone disease associated with total parenteral nutrition.
一名61岁男性因肠系膜动脉急性血栓形成接受了近乎全小肠切除术,术后在家接受了五年的全胃肠外营养治疗。治疗过程中出现了败血症、贫血和尿毒症等并发症。四年后,他出现了长骨和背部疼痛以及严重的高钙尿症。X线片显示骨质脱钙。无甲状旁腺功能亢进,血清磷酸盐和血清钙正常。他的慢性代谢性酸中毒通过肠内给予醋酸盐持续治疗。他接受了基础量的维生素D和氨基酸。通过给予降钙素,我们能够治愈他逐渐加重的骨痛,并使他的尿钙排出量恢复正常。未观察到副作用。因此,降钙素可能有助于治疗与全胃肠外营养相关的骨病。