唑来膦酸致严重低血钙、低血钾1例并文献复习

One case of hypocalcemia and hypokalemia induced by zoledronic acid and literature review

1例24岁女性患者确诊为原发性甲状旁腺功能亢进,甲状旁腺腺瘤,入院因血钙偏高给予唑来膦酸注射液5 mg,一次,静脉滴注,用药后22 h患者出现了肌肉酸痛、四肢麻木、手足抽搐,伴呼吸困难,查体:面神经叩击试验及束臂加压试验阳性,急查血钙2.05 mmol·L^(-1),血钾3.41 mmol·L^(-1)。用药第3天,血钙最低为1.47 mmol·L^(-1),血清白蛋白正常,用药第4天血钾最低为2.79 mmol·L^(-1),给予补钙、补钾等对症处理,用药第5天,患者查体面神经叩击试验及束臂加压试验阴性。用药第6天,患者复查血钙2.30 mmol·L^(-1),血钾2.99 mmol·L^(-1),血钾血钙均有所好转,转入普外科行手术治疗。

One case of 24-year-old female patient diagnosed as priamry hyperparathyroidism and parathyroid gland adenoma.After admission to hospital,the patient was administrated zoledronic acid injection 5 mg once intravenously because of high blood calcium.22 hours after administration,the patient had a muscular soreness,numbness of limbs,tetany,dyspnea,the facial nerve taps test and beam arm pressure test was positive,the blood calcium 2.05 mmol·L-1,potassium 3.41 mmol·L-1,hypocalcemia and hypokalemia gradually increased.3 days after administration,the minimum serum calcium was 1.47 mmol·L-1,serum albumin was normal.4 days after administration,the minimum serum potassium was 2.79 mmol·L-1.The patients was given calcium,potassium and other symptomatic treatment.5 days after administration,the body facial nerve taps test and beam arm pressure test were negative.6 days after administration,the result of recheck showed the serum calcium was 2.30 mmol·L-1,the serum potassium was 2.99 mmol·L-1,obviously improved.The patient was transferred to general surgery department for surgical treatment.