范可尼综合征-磷治疗-高钙血症  

Fanconi syndrome-phosphate therapy-hypercalcemia

作　　者：陈莹莹 段炼 王佳佳 朱庆莉[2] 花苏榕[3] 姜艳 李梅 夏维波 邢小平 王鸥 CHEN Ying-ying;DUAN Lian;WANG Jia-jia;ZHU Qing-li;HUA Su-rong;JIANG Yan;LI Mei;XIA Wei-bo;XING Xiao-ping;WANG Ou(Department of Endocrinology,key Laboratory of Endocrinology of National Health Commission,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical college,Beijing 100730,China;Department of Ultrasonography,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical college,Beijing 100730,China;Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&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,北京100730 [2]中国医学科学院北京协和医学院北京协和医院超声科,北京100730 [3]中国医学科学院北京协和医学院北京协和医院基本外科,北京100730

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2025年第1期83-93,共11页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：国家自然科学基金面上项目(82070817);中央高水平医院临床科研业务费资助(2022-PUMCH-B-014)。

摘　　要：三发性甲状旁腺功能亢进症可见于慢性肾脏病及长期应用中性磷制剂的患者,其病理基础是继发性甲状旁腺功能亢进背景下甲状旁腺受到持续性刺激发展为功能自主的增生或腺瘤。本文报道1例因长期不规范应用大剂量中性磷制剂并发三发性甲状旁腺功能亢进症的40岁女性范可尼综合征患者。患者因监测“空腹血磷低”,长期自行将中性磷制剂加量后出现血钙升高伴同步甲状旁腺激素(parathyroid hormone,PTH)不被抑制,甲状旁腺影像学提示多个甲状旁腺增生,考虑三发性甲状旁腺功能亢进症。经手术、西那卡塞治疗后,患者血钙、PTH较前明显下降。Tertiary hyperparathyroidism can be complicated in patients with chronic kidney disease and long-term phosphate therapy.Its pathological basis is that the parathyroid glands have been persistently stimulated under the background of secondary hyperparathyroidism,which leads to the development of the functional autonomic parathyroid hyperplasia or adenoma.In this article,a 40-year-old female patient with Fanconi syndrome was reported to be complicated by tertiary hyperparathyroidism after long-term high dose of phosphate therapy.Due to“low fasting serum phosphorus”,the patient increased the dose of neutral phosphate solution by herself for a long period,leading to hypercalcemia combined with elevated parathyroid hormone level.Imaging examinations indicated multiple parathyroid hyperplasia,so that tertiary hyperparathyroidism was suspected.The levels of serum calcium and PTH significantly decreased after parathyroidectomy and cinacalcet treatment.

关 键 词：范可尼综合征 中性磷制剂 三发性甲状旁腺功能亢进症 

分 类 号：R591.44[医药卫生—内科学] R582[医药卫生—临床医学]