Abstract:
Hyperparathyroidism is a syndrome characterized by an excessive secretion of parathyroid hormone. Etiologically, hyperparathyroidism is subdivided into primary hyperparathyroidism, which develops as a result of parathyroid adenoma, carcinoma or hyperplasia, and secondary hyperparathyroidism, which happens as a compensatory response to a hypocalcemia caused by condition outside the parathyroid glands. Turner syndrome may also be accompanied by mineral metabolism disorders of various etiology. An association of hyperparathyroidism and Turner syndrome is interesting because of multifactorial impact on bone mineral density, but only few cases of such coexistence have been previously described in the literature. This article describes two patients with Turner syndrome and hyperparathyroidism of different etiology. Hyperparathyroidism, normocalcemia, vitamin D deficiency, osteoporosis, parathyroid tumors were found in both cases. In one case a number of assays was performed to confirm the patient\'s normocalcemic primary hyperparathyroidism, and surgery was performed to achieve remission. In the second case, treatment of vitamin D deficiency resulted in normalization of serum concentration of parathormone, after which the patient was prescribed antiresorptive therapy. The pathogenetic association between Turner syndrome and hyperparathyroidism requires further investigation. Comprehensive approach to the diagnosis and treatment of mineral metabolism disorders are essential for patients with coexistence of these two diseases.
摘要:
甲状旁腺功能亢进是一种以甲状旁腺激素分泌过多为特征的综合征。病因学上,甲状旁腺功能亢进分为原发性甲状旁腺功能亢进,它是由甲状旁腺腺瘤引起的,癌或增生,继发性甲状旁腺功能亢进,这是对由甲状旁腺外的疾病引起的低钙血症的代偿反应。特纳综合征还可能伴有各种病因的矿物质代谢紊乱。甲状旁腺功能亢进和特纳综合征的关联是有趣的,因为对骨密度的多因素影响,但是以前文献中只描述了很少的这种共存的情况。本文介绍了两种不同病因的特纳综合征和甲状旁腺功能亢进患者。甲状旁腺功能亢进,正常钙血症,维生素D缺乏,骨质疏松,在两个病例中都发现了甲状旁腺肿瘤。在一个病例中,进行了许多试验以确认患者的正常血钙原发性甲状旁腺功能亢进。并进行手术以达到缓解。在第二种情况下,治疗维生素D缺乏导致血清副激素水平正常化,之后,患者接受了抗再吸收治疗。特纳综合征与甲状旁腺功能亢进之间的致病关联需要进一步研究。矿物质代谢障碍的诊断和治疗的综合方法对于这两种疾病并存的患者至关重要。