原发性甲状旁腺功能亢进症五例误诊分析  

Misdiagnosis Analysis of 5 Patients with Primary Hyperparathyroidism

作　　者：王文璋 王幼黎[1] 高举[1] 

机构地区：[1]中国航空工业中心医院普通外科,北京100012

出　　处：《临床误诊误治》2011年第7期51-53,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨原发性甲状旁腺功能亢进症(primary Hyperparathyroidism,PHPT)的误诊原因,提出减少误诊的对策。方法回顾分析5例PHPT误诊的临床资料。结果本组表现为四肢关节疼痛5例,伴随多发肾结石3例,多发性病理骨折2例,四肢肌肉疼痛伴肌无力1例。5例分别误诊为肌营养不良、病理性骨折、肾结石、骨质疏松、风湿性关节炎等,部分病例多次误诊。5例查血钙、血磷异常,甲状旁腺激素明显升高,经颈部B超或CT检查发现甲状旁腺肿瘤,均接受手术治疗,术后病理诊断均为甲状旁腺腺瘤。结论临床医生应提高对PHPT的认识,对疑诊患者早期检测血钙、血磷和甲状旁腺激素,行颈部B超和CT检查定位诊断,降低误诊率。Objective To investigate the misdiagnosis cause of primary hyperparathyroidism （PHPT）, and to propose measures to reduce misdiagnosis. Methods The clinical data of 5 patients with PHPT were retrospectively analyzed. Results 5 patients had pain in the limbs and joints, 3 had multiple kidney calculi, 2 had multiple pathologic fractures, and 1 had muscles pain in limbs with muscle weakness. The patients were misdiagnosed as having muscular dystrophy, pathologic fracture, kidney calculi, osteoporosis, rheumatic arthritis respectively, and some of them had been misdiagnosed several times. Serum calcium and phosphorus level of the 5 patients were abnormal, and parathormone increased significantly. Parathyroid neoplasm was found by ultrasound and CT detection, and all the patients were confirmed as having parathyroid neoplasm after operations. Conclusion Clinicians should raise awareness of PHPT, detection of the levels of serum calcium and phosphorus and serum parathyroid hormone （PTH）, and localizational diagnosis by cervical ultrasound and CT examinations can reduce misdiagnosis rate.

关 键 词：甲状旁腺功能亢进症 误诊 关节炎 风湿性 肾结石 骨质疏松 

分 类 号：R582.1[医药卫生—内分泌]