Bergdahl L
Am J Surg. 1977 Feb;133(2):206-10. doi: 10.1016/0002-9610(77)90081-2.
The frequency of hypercalcemia in 295 patients treated for thyrotoxicosis was 2 per cent. The combination of thyrotoxicosis and hyperparathyroidism is rare and only twenty-seven well documented cases could be found in the literature. Among ninety-two patients operated on for hyperparathyroidism, ten of them had thyrotoxicosis. In the present study, data on thirty-seven patients are reported. Hypercalcemia was found in all the patients and four of them had acute hyperparathyroidism. Hypophosphatemia was recorded in 60 per cent and hypercalcuria in 75 per cent of the patients. In ten patients there were renal concretions. Skeletal roentgenograms showed abnormalities in 65 per cent of the patients. In no instance had hyperparathyroidism commenced before thyrotoxicosis. Other recent reports on the etiology of hyperparathyroidism are discussed and it is concluded that hyperparathyroidism in thyrotoxicosis is a secondary disease. If a thyrotoxic patient with hypercalcemia still has elevated calcium values when becoming euthyroid after thyrostatic treatment, an operation should be performed. Because of a high recurrence rate in such patients with adequate follow-up, "near total parathyroidectomy" is recommended.
295例甲状腺毒症患者中高钙血症的发生率为2%。甲状腺毒症与甲状旁腺功能亢进合并的情况罕见，文献中仅能找到27例有充分记录的病例。在92例因甲状旁腺功能亢进而接受手术的患者中，有10例患有甲状腺毒症。在本研究中，报告了37例患者的数据。所有患者均发现高钙血症，其中4例患有急性甲状旁腺功能亢进。60%的患者记录有低磷血症，75%的患者有高钙尿症。10例患者有肾结石。骨骼X线片显示65%的患者有异常。甲状旁腺功能亢进从未在甲状腺毒症之前出现过。讨论了近期关于甲状旁腺功能亢进病因的其他报告，并得出结论，甲状腺毒症中的甲状旁腺功能亢进是一种继发性疾病。如果甲状腺毒症伴高钙血症的患者在接受抗甲状腺治疗后甲状腺功能恢复正常时血钙值仍升高，则应进行手术。由于此类患者在充分随访时有较高的复发率，建议行“近全甲状旁腺切除术”。
