Osteomalacia as a very late manifestation of primary hyperparathyroidism.
Osteomalacia as a very late manifestation of primary hyperparathyroidism.
复制标题
骨软化症是原发性甲状旁腺功能亢进症的晚期表现。
DOI：
10.1097/00003086-198803000-00004
复制
发表时间：
1988
影响因子：
4.2
通讯作者：
E. Raffensperger
中科院分区：
文献类型：
--
作者：
F. Kaplan;S. Soffer;M. Fallon;J. Haddad;M. Dalinka;E. Raffensperger
一名86岁女性，有甲状腺功能亢进症治疗史和20年原发性甲状旁腺功能亢进症未治疗史，出现全身性骨痛和左股骨中段假性骨折。实验室检查显示血清钙、碱性磷酸酶和C-末端甲状旁腺激素水平升高。血清无机磷低于正常值，25-羟基维生素D水平低于正常值。四环素双标记后的不脱钙髂骨活检标本显示骨软化症和纤维性骨炎。经过维生素D和磷酸盐治疗后，血清无机磷酸盐水平升至正常。骨痛减轻，假性骨折愈合。然而，血清钙，碱性磷酸酶，和C-末端甲状旁腺激素水平仍然升高。长期原发性甲状旁腺功能亢进引起慢性低磷血症，并可能导致骨软化。骨软化症及其后果可能是长期原发性甲状旁腺功能亢进患者所见骨疾病谱的一部分。
An 86-year-old woman with a history of treated hyperthyroidism and a 20-year history of untreated primary hyperparathyroidism developed generalized bone pain and a pseudofracture of the midshaft of the left femur. Laboratory examinations revealed elevated serum calcium, alkaline phosphatase, and C-terminal parathyroid hormone levels. Serum inorganic phosphate was below normal and 25-hydroxyvitamin D levels were low-normal. An undecalcified transiliac bone biopsy specimen following tetracycline double labeling revealed osteomalacia and osteitis fibrosa. Following treatment with vitamin D and phosphate, the serum inorganic phosphate level rose to normal. There was a decrease in bone pain, and the pseudofracture healed. However, the serum calcium, alkaline phosphatase, and C-terminal parathyroid hormone levels remained elevated. Longstanding primary hyperparathyroidism causes chronic hypophosphatemia and may lead to osteomalacia. Osteomalacia and its consequences may be part of the spectrum of bone disease seen in patients with longstanding primary hyperparathyroidism.