Cömlekçi A, Biberoglu S, Hekimsoy Z, Okan I, Pişkin O, Sekeroglu B, Alakavuklar M
Dokuz Eylül University, Medical Faculty, Department of Internal Medicine, Inciralti, Izmir, Turkey.
Intern Med. 1998 Apr;37(4):396-7. doi: 10.2169/internalmedicine.37.396.
Pamidronate is an effective drug used not only in patients with tumor-associated hypercalcemia, but also in normocalcemic patients with metastatic bone disease to relieve pains. We describe a 39-year-old normocalcemic patient with subclinical hypoparathyroidism and bone metastasis due to breast carcinoma. Following parenteral administration of 60 mg pamidronate, the corrected serum level of calcium decreased from 2.12 mmol/l (=8.9 mg/dl) to 1.42 mmol/l (5.7 mg/dl), accompanied with carpal pedal spasm. The present case indicates that the hypocalcemia due to latent hypoparathyroidism was compensated by extensive osteolysis due to bone metastasis, and that overt hypocalcemia may develop after intravenous administration of pamidronate in such a patient.
帕米膦酸盐是一种有效的药物，不仅用于治疗肿瘤相关性高钙血症患者，也用于治疗转移性骨病的血钙正常患者以缓解疼痛。我们描述了一名39岁的血钙正常患者，患有亚临床甲状旁腺功能减退症且因乳腺癌发生骨转移。静脉注射60mg帕米膦酸盐后，校正后的血清钙水平从2.12mmol/L（=8.9mg/dl）降至1.42mmol/L（5.7mg/dl），并伴有手足搐搦。本病例表明，由于骨转移导致的广泛骨质溶解代偿了潜在甲状旁腺功能减退引起的低钙血症，并且在这类患者静脉注射帕米膦酸盐后可能会出现明显的低钙血症。
