以低钙血症抽搐表现的严重维生素D缺乏性骨软化症一例  

Severe vitamin D deficiency induced osteomalacia with hypocalcemic tetany: a case report

作　　者：吴博[1] 夏维波[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院内分泌科国家卫生和计划生育委员会内分泌重点实验室,北京100730

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2016年第1期59-64,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：国家自然科学基金(81070687;81170805)

摘　　要：维生素D缺乏可引起成年患者骨软化症,出现疼痛、骨骼畸形、活动障碍等。严重缺乏者可出现低钙血症、抽搐。本文报道1例罕见的维生素D严重缺乏老年女性患者,以长期骨痛,近期出现抽搐、呼吸困难为主要临床表现就诊。实验室检查提示血钙降低,血碱性磷酸酶(alkaline phosphatase,ALP)升高,血甲状旁腺素(parathyroid hormone,PTH)升高,血25羟维生素D(25-hydroxy vitamin D,25OHD)水平低于检测值下限,影像学检查提示腰椎压缩性骨折。给予钙剂、活性维生素D制剂后血钙恢复正常,抽搐症状消失。长期予维生素D补充治疗,骨痛症状缓解。本文同时对维生素D缺乏引起低钙抽搐的病例报告文献进行复习和总结。Osteomalacia could be induced by vitamin D deficiency in adult patients,presented with skeletal pain,deformation and impaired activities. The severe vitamin D deficiency may induce hypocalcemia and tetany. This study reported a rare case of severe vitamin D deficiency in an old woman,who suffered from skeletal pain for a long time,and underwent tetany and hypocalcemia for a short time. The laboratory test showed that serum calcium was decreased,serum alkaline phosphatase（ ALP） and parathyroid hormone（ PTH） were elevated,the serum concentration of25-hydroxy vitamin D was belowed the minimum detection value. Imageological examination indicated compression fracture in lumbar vertebra. The serum calcium normalized and tetany stopped after supplementary therapy of calcium and activated vitamin D,and the skeletal pain alleviated after the supplementary of vitamin D. We also reviewed the related literatures about vitamin D deficiency induced hypocalcemic tetany,secondary hyperparathyroidism and fracture.

关 键 词：低钙血症 骨软化症 维生素D缺乏 继发性甲状旁腺功能亢进 

分 类 号：R681[医药卫生—骨科学]