Remission of Primary Hyperparathyroidism Due To Spontaneous Infarction of a Parathyroid Adenoma: Case Report and Review of the Literature
Remission of Primary Hyperparathyroidism Due To Spontaneous Infarction of a Parathyroid Adenoma: Case Report and Review of the Literature
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甲状旁腺腺瘤自发性梗死所致原发性甲状旁腺功能亢进症的缓解：病例报告及文献复习
DOI：
10.1097/00005792-199811000-00005
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发表时间：
1998
期刊：
影响因子：
1.6
通讯作者：
John D. L. Gay
中科院分区：
文献类型：
--
作者：
K. A. Kovacs;John D. L. Gay
异常甲状旁腺组织的亚临床梗死可能相对频繁发生，但由于甲状旁腺腺瘤自发性大面积梗死导致原发性甲状旁腺功能亢进的缓解是罕见的。我们描述了一个病人谁是独特的，自发缓解是伴随着消失的甲状旁腺腺瘤序列甲状旁腺扫描。我们在文献中发现了另外11例因甲状旁腺腺瘤自发性大面积梗死导致原发性甲状旁腺功能亢进临床缓解的患者，并回顾了他们的临床特征。根据诊断延迟、血清钙改变、出血部位和程度不同，其表现也不同。年龄从19岁到73岁不等，男女都受到影响。10例病例存在提示高钙血症的既往症状和/或既往记录的高钙血症。6/12例患者在梗死时出现颈部疼痛，7/12例患者出现颈部肿块。仅1例患者死亡。梗死后7/12例患者的初始钙水平为"正常"，3/12例为低，2/12例为高。8/12例患者的甲状旁腺腺瘤≥ 2 cm。在所有接受甲状旁腺切除术的患者中，组织病理学证实了腺瘤的广泛梗死（无症状或出血性）。遇到的临床情况是3例低钙危象，2例高钙危象（"急性甲状旁腺中毒"），1例继发于纵隔血肿的呼吸骤停，2例以颈部疼痛为主诉的患者，4例除高钙血症的病前症状外无其他症状。
Subclinical infarction of abnormal parathyroid tissue likely occurs relatively frequently, but remission of primary hyperparathyroidism due to spontaneous massive infarction of a parathyroid adenoma is a rare occurrence. We describe a patient who was unique in that spontaneous remission was accompanied by disappearance of the parathyroid adenoma on serial parathyroid scans. We identified 11 other patients in the literature with sufficient documentation of clinical remission of primary hyperparathyroidism due to spontaneous massive infarction of a parathyroid adenoma and review their clinical features as well. Manifestations varied according to the delay in diagnosis, alteration in serum calcium, location, and degree of associated hemorrhage. Ages ranged from 19 to 73 years, and both sexes were affected. Preceding symptoms suggestive of hypercalcemia and/or prior documentation of hypercalcemia were present in 10 cases. Neck pain was present at the time of infarction in 6/12 patients, and a neck mass in 7/12. Only 1 patient died. The initial calcium level done postinfarction was "normal" in 7/12 patients, low in 3/12, and high in 2/12. The parathyroid adenoma was 2 cm or larger in 8/12 patients. In all patients who had parathyroidectomy, histopathology confirmed extensive infarction (bland or hemorrhagic) of the adenoma. The clinical scenarios encountered were 3 hypocalcemic crises, 2 hypercalcemic crises ("acute parathyroid intoxication"), 1 respiratory arrest secondary to a mediastinal hematoma, 2 patients with neck pain as the major complaint, and 4 with no symptoms apart from the premorbid symptoms of hypercalcemia.
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DOI：
10.1016/s0022-3476(89)80290-2
发表时间：
1989
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Batshaw,ML;Naylor,EW;Thomas,GH
通讯作者：
Thomas,GH
影响因子：
56.9
作者：
LINDGREN, V;DEMARTINVILLE, B;FRANCKE, U
通讯作者：
FRANCKE, U
影响因子：
56.9
作者：
HORWICH, AL;FENTON, WA;ROSENBERG, LE
通讯作者：
ROSENBERG, LE
影响因子：
158.5
作者：
Maestri, NE;Brusilow, SW;Bassett, SS
通讯作者：
Bassett, SS
影响因子：
5.1
作者：
MAESTRI, NE;MCGOWAN, KD;BRUSILOW, SW
通讯作者：
BRUSILOW, SW