原发性甲状旁腺功能亢进症合并意义未明单克隆丙种球蛋白血症一例报告及文献复习  

Primary hyperparathyroidism with monoclonal gammopathy of undetermined significance:a case report and literature review

作　　者：苏静 李志辉[3] 卢春燕[1] SU Jing;LI Zhi-hui;LU Chun-yan(Department of Endocrinology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Endocrinology,Mianzhu People's Hospital,Mianzhu 618200,Sichuan,China;Department of Thyroid Surgery,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院内分泌代谢科,成都610041 [2]四川省绵竹市人民医院内分泌代谢科,四川绵竹618200 [3]四川大学华西医院甲状腺外科,成都610041

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2024年第3期240-245,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)是内分泌常见疾病,但合并意义未明单克隆丙种球蛋白血症(monoclonal gammopathy of undetermined significance,MGUS)的报道较少。本文报道一例55岁女性,临床表现为逐渐加重的腰背部疼痛。辅助检查提示甲状旁腺激素(parathyroid hormone,PTH)升高、高钙血症和低磷血症。颈部超声造影和甲状旁腺放射性核素显像均提示甲状腺右侧叶下极下方实性结节。术后病理诊断甲状旁腺腺瘤。免疫固定电泳提示IgAλ型M蛋白增高,结合骨髓涂片等诊断为MGUS。Primary hyperparathyroidism(PHPT)is a common endocrine disease,but PHPT complicated with monoclonal gammopathy of undetermined significance(MGUS)is rarely reported.In this article,a case of a 55-year-old woman presented with progressively aggravated skeletal pain was reported.Laboratory examination revealed high parathyroid hormone(PTH),hypercalcemia and hypophosphoremia.Contrast-enhanced ultrasonography and radionuclide imaging of the parathyroid gland revealed solid nodulations below the right inferior pole of the thyroid gland.Postoperative pathological diagnosis was parathyroid adenoma.M protein of IgAλ was detected by immunofixation electrophoresis.Combined with bone marrow smear,monoclonal gammopathy of undetermined significance(MGUS)was diagnosed.

关 键 词：原发性甲状旁腺功能亢进症 意义未明单克隆丙种球蛋白血症 甲状旁腺腺瘤 

分 类 号：R582.1[医药卫生—内分泌] R553[医药卫生—内科学]