原发性甲状旁腺功能亢进症相关肾损害

Primary hyperparathyroidism associated kidney injury

中老年女性,临床以嗳气、便秘、双下肢乏力、关节痛等为主要表现起病。实验室检查发现血清肌酐升高,无蛋白尿及血尿,同时伴高钙血症、甲状旁腺激素水平升高;肾脏B超提示双肾结晶。肾活检病理表现为慢性间质性肾炎伴肾钙质沉着症。右侧甲状旁腺切除术后病理提示为甲状旁腺腺瘤。最终诊断为甲状旁腺腺瘤、原发性甲状旁腺功能亢进症、慢性间质性肾炎伴肾钙质沉着症。

A 63-year-old woman presented with belching,constipation,lower extremities weakness and arthralgia.Laboratory tests showed hypercalcemia,elevated serum creatinine and parathyroid hormone.Urine analysis did not find proteinuria or hematuria.Kidney ultrasound demonstrated bilateral kidney crystal.Renal biopsy showed chronic interstitial nephritis and nephrocalcinosis.Parathyroidectomy was then performed and pathological examination indicated parathyroid adenoma.The final diagnosis was parathyroid adenoma and primary hyperparathyroidism associated kidney calcinosis.