PDF(Pubmed)
Abstract：
Two patients aged 82 and 77, with a fractured neck of the femur, were found to have primary hyperparathyroidism, characterized by hypercalcemia and hypercalciuria. Post-surgery, both developed pulmonary embolism (PE), highlighting a possible link between hypercalcemia and increased hypercoagulation risk. There have been few case reports suggesting the association between hypercalcemia due to hyperparathyroidism and the increase in tendency of hypercoagulation and subsequent risk of venous thromboembolism (VTE). This case series offers insights into how ionized calcium influences thrombin formation, platelet activation and aggregation, and activation of clotting factors such as factor VII and factor X, raising questions about the role of chronic hypercalcemia in VTE. Further research is needed to 1) establish whether chronic hypercalcemia in the absence of fracture can modulate the risk of hypercoagulation; 2) determine whether chronic hypercalcemia in individuals with bone fracture may represent a significantly higher hypercoagulability risk during the postoperative periods.
摘要：
两名年龄分别为82岁和77岁的股骨颈骨折患者，被发现患有原发性甲状旁腺功能亢进，以高钙血症和高钙尿症为特征。手术后,两者均发展为肺栓塞（PE），强调高钙血症和高凝风险增加之间可能的联系。很少有病例报告表明甲状旁腺功能亢进引起的高钙血症与高凝倾向增加以及随后的静脉血栓栓塞（VTE）风险之间存在关联。这个案例系列提供了离子钙如何影响凝血酶形成的见解，血小板活化和聚集，和凝血因子如因子VII和因子X的激活，对慢性高钙血症在VTE中的作用提出了质疑。需要进一步的研究以1）确定没有骨折的慢性高钙血症是否可以调节高凝的风险；2）确定骨折患者的慢性高钙血症在术后期间是否可能代表明显更高的高凝风险。
