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甲状旁腺功能减退症-高钙血症-钙碱综合征

Hypoparathyroidism-hypercalcemia-calcium-alkali syndrome

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【作者】 李汇李京艳吕莉范雨鑫李淑英戴晨琳崔景秋何庆刘铭

【Author】 LI Hui;LI Jing-yan;LV Li;FAN Yu-xin;LI Shu-ying;DAI Chen-lin;CUI Jing-qiu;HE Qing;LIU Ming;Department of Endocrinology and Metabolism,Tianjin Medical University General Hospital;

【通讯作者】 刘铭;

【机构】 天津医科大学总医院内分泌代谢科

【摘要】 近年来,随着钙剂的广泛应用,钙碱综合征(calcium-alkali syndrome, CAS)发生率增加。CAS又称新型乳碱综合征,其和乳碱综合征(milk-alkali syndrome, MAS)的典型表现相同,包括高钙血症、代谢性碱中毒、肾功能不全。甲状旁腺功能减退症(hypoparathyroidism, HP)是罕见的内分泌疾病,临床特征包括低钙血症、高磷血症、神经肌肉兴奋性增高等,需长期口服钙片和活性维生素D治疗。HP患者发生高钙血症的报道少见,本文报道1例40年HP病史的患者,在治疗过程中发生高钙危象并成功救治,诊断为CAS,提示临床医生在HP患者的治疗过程中,需密切监测血钙、磷情况,注意肾功能、合并用药、应激状态,警惕CAS的发生。

【Abstract】 With the wide application of calcium supplements in recent years, the incidence of calcium-alkali syndrome(CAS) increases. CAS is also called new milk-alkali syndrome, and has the almost same typical manifestations with milk-alkali syndrome(MAS) such as hypercalcemia, metabolic alkalosis and renal insufficiency. Hypoparathyroidism(HP) is a rare endocrine disease with clinical features like hypocalcemia, hyperphosphatemia and increased neuromuscular excitability, which requires long-term treatment of oral calcium and vitamin D. Hypercalcemia in HP patients has rarely been reported. In this article a patient with HP for 40 years developed hypercalcemia crisis during the routine treatment and was successfully cured with the diagnosis of CAS, which suggested clinicians of close monitoring of blood calcium and phosphorus and paying attention to renal function, drug combination and stress state during the treatment of HP patients,so as to be alert to the occurrence of CAS.

【基金】 天津市医学重点学科(专科)建设项目(TJYXZDXK-030A)
  • 【文献出处】 中华骨质疏松和骨矿盐疾病杂志 ,Chinese Journal of Osteoporosis and Bone Mineral Research , 编辑部邮箱 ,2024年05期
  • 【分类号】R582.2;R589.5
  • 【下载频次】18
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