Molina M J, Lara J I, Riobo P, Guijarro S, Moreno A, Del Peso C, Gonzalo A, Rovira A, Herrera-Pombo J L
Department of Endocrinology and Nutrition, Clinica Nuestra Señora De La Concepcion, Ciudad Universitaria, Madrid, Spain.
Am J Med Sci. 1996 Jun;311(6):296-8. doi: 10.1097/00000441-199606000-00014.
A patient with myotonic dystrophy and associated primary hyperthyroidism and hyperparathyroidism is described; this association has not been reported previously, to the authors' knowledge. The patient also suffered from hypergonadotropic hypogonadism and hyperinsulinism with insulin resistance. The etiology of hyperthyroidism and hyperparathyroidism is not clear. At surgery, a parathyroid adenoma was extirpated, and a subtotal thyroidectomy was performed. Postoperative course was unremarkable, with consistently normal serum calcium levels but persistently elevated serum parathyroid hormone concentrations. The possibility that the patient had a residual hyperparathyroidism could not be eliminated. Thyroid function was normal. After surgery, the patient reported subjective improvement in his muscle strength. The authors conclude that both diseases-- hyperthyroidism and hyperparathyroidism--exert a negative effect on the myotonic dystrophy and that an early recognition of these two diseases is crucial for the favorable evolution of the patient.
本文描述了一名患有强直性肌营养不良并伴有原发性甲状腺功能亢进和甲状旁腺功能亢进的患者；据作者所知，这种关联此前尚未有过报道。该患者还患有促性腺激素分泌过多性性腺功能减退和伴有胰岛素抵抗的高胰岛素血症。甲状腺功能亢进和甲状旁腺功能亢进的病因尚不清楚。手术中，切除了一个甲状旁腺腺瘤，并进行了甲状腺次全切除术。术后过程平稳，血清钙水平持续正常，但血清甲状旁腺激素浓度持续升高。不能排除患者存在残余甲状旁腺功能亢进的可能性。甲状腺功能正常。手术后，患者报告主观感觉肌肉力量有所改善。作者得出结论，甲状腺功能亢进和甲状旁腺功能亢进这两种疾病均对强直性肌营养不良产生负面影响，早期识别这两种疾病对患者的良好病情发展至关重要。
