特发性甲状旁腺机能减退5例诊治分析  

A retrospective analysis of five cases with idiopathic hypoparathyroidism

作　　者：梁建民[1] 陈希学[2] 张亚英[1] 李海波[1] 徐乃军[1] 杜红伟[1] 

机构地区：[1]吉林大学白求恩第一医院儿科,吉林长春130021 [2]双辽市人民医院儿科,吉林双辽136400

出　　处：《中风与神经疾病杂志》2011年第6期535-537,共3页Journal of Apoplexy and Nervous Diseases

基　　金：中国博士后基金(2005037033);吉林省自然科学基金(201015147);长春市科技局儿科诊疗中心重点专科建设项目(2010120)

摘　　要：目的提高对特发性甲状旁腺功能减退症(idiopathic hypoparathyroidism,IHP)的认识,减少临床误诊。方法对5例IHP患儿的临床资料进行分析和文献回顾。结果 5例患儿中有3例以癫痫发作为首发症状,被长期误诊为原发性癫痫,1例以头痛为首发症状,伴有头晕,被误诊为偏头痛;1例以乏力和胸闷为首发症状、被误诊为心肌炎。5例患儿均有不同程度的手足搐搦史,2例有精神症状,1例有智力受损,5例均有血钙降低、血磷增高及血甲状旁腺激素(parathormone,PTH)降低。5例头部CT均有颅内双侧基底节钙化,其中3例伴有丘脑、小脑齿状核和皮质-髓质交界区广泛性对称性钙化。结论 IHP临床症状复杂,容易误诊为癫痫、偏头痛或心肌炎等疾病,应尽早检查头部CT、血钙、血磷和PTH确立诊断。Objective To better understand the clinical feature of idiopathic hypoparathyroidism（IHP） and decrease clinical misdiagnosis.Methods Five cases of IHP were studied by using retrospective analysis along with a short review of literature.Results Three of the 5 cases were mistaken for epilepsy for a long period of time for their initial symptoms were seizure disorder,the fourth one was mainly present headache accompanied by dizziness,and was mistaken for migraine,the last one was complaint with fatigue and chest oppression and was misdiagnosed as myocarditis.Tetany was occurred in all cases.Psychiatric symptom was occurred in 2 cases.Intelligence damage was occurred in 1 case.The decrease of serum calcium level and parathyroid hormone（PTH） level and the increase of serum phosphonium level occurred in all 5 cases.The calcification of bilateral basal ganglion on CT scan occurred in all 5 cases,including 3 cases with the calcification of bilateral thalamus,cerebellar dentate nucleus,cortical-medulla boundary.Conclusion IHP always presents with complex feature,which may be mistaken for epilepsy,migraine,myocarditis or some other diseases.Examination of CT scan,serum calcium,serum phosphonium and PTH level earlier is very important for establish IHP diagnosis.

关 键 词：甲状旁腺机能减退 癫痫 

分 类 号：R582.2[医药卫生—内分泌]