多尿-肾功能异常-高钙危象-高甲状旁腺素血症

Polyuria-renal dysfunction-hypercalcemia-hyperparathyrosinemia

甲状旁腺癌是罕见的内分泌恶性肿瘤,多数患者会出现高钙血症伴有肾脏、骨骼等多系统症状。高钙血症的纠正是本病治疗的关键和逆转脏器损害的核心。本文报道1例甲状旁腺癌导致高钙危象,继发急性肾损伤、蛋白尿和多尿患者,采用内科药物降钙治疗效果欠佳,在血液净化治疗控制血钙水平的同时行手术治疗后病情好转,提示在处理高钙血症过程中血液净化治疗有重要作用,针对原发病的治疗是控制高钙血症的关键。

Parathyroid carcinoma is a rare kind of endocrine malignancy.Most patients will develop hypercalcemia and systemic involvement of kidney,bone,and other organs.Correction of hypercalcemia is critical in treating parathyroid carcinoma.We reported one case with parathyroid carcinoma complicated with severe hypercalcemia,acute kidney injury,proteinuria,and polyuria.Medical treatment failed to control the hypercalcemia.Continuous renal replacement treatment was deployed to control the serum calcium and right parathyroidectomy was performed.This case suggests that blood purification treatment is of great value in correction of hypercalcemia and the therapies targeting the primary cause was important.