以腰腿痛为主要表现的PHPT病人8例临床分析

PRIMARY HYPERPARATHYROIDISM WITH WAIST AND LEG PAIN AS THE MAIN MANIFESTATION: A CLINICAL ANALYSIS OF EIGHT CASES

目的 探讨以腰腿痛首诊的原发性甲状旁腺功能亢进症(PHPT)病人的临床特征,提高临床医生对该病认识,减少其误诊误治。方法 分析以腰腿痛就诊的8例PHPT病人的临床表现及诊疗过程。结果 8例病人主要症状为腰背部或下肢疼痛;4例病人表现为腰痛伴肢体乏力,3例病人表现为腰痛伴下肢疼痛,1例病人表现为腰背部疼痛合并下肢疼痛。初诊误诊为原发性骨质疏松椎体压缩性骨折3例,腰椎间盘突出症3例,腰椎椎管狭窄症2例。结论 PHPT可以腰腿痛为首发表现就诊于脊柱外科,诊断椎体骨折、腰椎间盘突出症、腰椎椎管狭窄症应警惕PHPT的存在。

Objective To investigate the clinical features of patients with primary hyperparathyroidism(PHPT) with waist and leg pain at initial diagnosis, to improve the awareness of this disease among clinicians, and to reduce misdiagnosis and mistreatment. Methods Eight patients with PHPT who attended the hospital due to waist and leg pain were analyzed in terms of clinical manifestation and diagnosis. Results All eight patients had the main symptom of pain in lower back or lower limbs, among whom four had waist pain and limb weakness, three had waist pain and pain in lower limbs, and one had lower back pain and pain in lower limbs. As for misdiagnosis at initial diagnosis, three patients were misdiagnosed as primary osteoporotic vertebral compression fractures, three were misdiagnosed as lumbar disc herniation, and two were misdiagnosed as lumbar spinal stenosis. Conclusion Patients with PHPT may attend department of spinal surgery due to the initial manifestation of waist and leg pain, and the presence of PHPT should be considered for the diagnosis of vertebral fracture, lumbar disc herniation, and lumbar spinal stenosis.