畸形性骨炎伴低血钙、低血磷一例

Paget's disease coupled with hypocalcemia and hypophosphatemia

报道1例畸形性骨炎,又称Paget骨病(Paget's disease,PD)伴低血钙、低血磷病例。患者是围绝经期女性,以骨痛,血碱性磷酸酶增高以及骨骼影像学特征性病变明确诊断为Paget骨病,用唑来膦酸治疗后骨痛减轻,X线片提示多骨损害有好转。但是,不同于典型Paget骨病,该患者血钙、血磷及维生素D水平降低,甲状旁腺素增高。本文结合文献复习,总结分析伴钙、磷代谢异常Paget骨病的临床表现、实验室检查和治疗情况,以期提高临床医师对本病的认识、为临床诊治积累更多经验。

We report a case of osteitis deforms, diagnosed as Paget＇s disease of bone （ PD）, with hypocalcemia and hypophosphatemia. The patient was a postmenopausal female and was diagnosed as PD according to presentations of bone pain, increased serum alkaline phosphatase level, and radiological characteristics of bone lesions, which were improved after the treatment of zoledronic acid. However, the patient had the decreased levels of serum calcium, phosphorus, and 25-hydroxy vitamin D （25 OHD） and increased level of serum parathyroid hormone, which were relatively rare in typical PD cases. In order to provide more experience of diagnosis and treatment of the disease, the clinical characters of Paget＇s disease of bone with abnormal serum calcium and phosphate were reviewed.