高钙血症—甲状腺结节—肾功能不全—双肺结节  

Hypercalcemia,thyroid nodules,impairment of renal function,and pulmonary nodules

作　　者：王雪晨 齐文婷 王鸥 卢琳 黄慧[2] 毛歆歆[3] 段炼 WANG Xue-chen;QI Wen-ting;WANG Ou;LU Lin;HUANG Hui;MAO Xin-xin;DUAN Lian(Department of Endocrinology,Key Laboratory of Endocrinology,National Health Commission,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Pulmonary and Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China;Department of Pathology,Peking Union Medical College Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Beijing 100730,China)

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、国家卫生健康委员会内分泌重点实验室、疑难重症及罕见病全国重点实验室,北京100730 [2]中国医学科学院北京协和医学院北京协和医院呼吸与危重症医学科,北京100730 [3]中国医学科学院北京协和医院病理科,北京100730

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2024年第4期352-357,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：北京协和医学院2021年度校级本科教育教学改革项目(2021zlgc0109)。

摘　　要：本文报告1例67岁女性,因“纳差、乏力6个月余,发现血钙升高4个月”于2023年8月就诊于北京协和医院内分泌科。临床表现高钙危象且甲状旁腺素(parathyroid hormone,PTH)被抑制,同时伴有肾功能不全、双肺结节、甲状腺结节等多系统受累。经筛查除外肿瘤等其他非PTH依赖性高钙血症病因,结合外院甲状腺手术病理组织学特征诊断为结节病。住院期间予鲑鱼降钙素和地舒单抗降血钙,待诊断明确后予糖皮质激素联合免疫抑制剂治疗原发病,随访监测患者血钙持续正常,贫血纠正,肾功能改善。We report a case of a 67-year-old female admitted to Peking Union Medical College Hospital due to anorexia,fatigue and hypercalcemia.The patient presented with hypercalcemic crisis with suppressed parathyroid hormone(PTH),impairment of renal function,pulmonary nodules,and thyroid nodules.After excluding other causes of PTH-independent hypercalcemia,the patient was diagnosed with sarcoidosis by pathological examination of surgically removed thyroid tissues.For management of hypercalcemic crisis,the patient was given subcutaneous injection of calcitonin and denosumab.The patient was then treated with corticosteroids and immunosuppressants.The hypercalcemia,anemia and impairment of renal function resolved.

关 键 词：高钙危象 甲状腺肿物 肾功能不全 结节病 

分 类 号：R581[医药卫生—内分泌]