International Journal of Clinical Research
International Journal of Clinical Research. 2021; 5: (4) ; 10.12208/j.ijcr.20210033 .
总浏览量: 1062
中山大学附属第七医院（深圳）内分泌科 深圳
*通讯作者： 李芳萍,单位：中山大学附属第七医院（深圳）内分泌科 深圳；
高钙血症病因复杂，临床表现缺乏特异性，不易及时发现并进一步寻找病因。本文报告一例因反复季肋部疼痛，经过9个月的就诊，最终以多发肋骨骨折、腰椎骨质疏松、血钙升高、血磷下降、PTH降低、血清蛋白电泳发现M蛋白条带为诊疗线索，确诊为“多发性骨髓瘤”的病例，复习高钙血症的诊疗思路，以尽早进行病因诊断。
Etiologies of hypercalcemia are complicated, the symptoms are nonspecific which is not easy to be found. Here we reported the case of a woman suffered from costal pain for 9 months and finally diagnosed with Multiple myeloma by multi-rib fracture, lumber osteoposis, hypercalcemia, hypophosphatemia, low parathyroid hormone and serum protein electrophoresis found M protein. We review the diagnostic strategies of hypercalcemia for further identification of etiologies as early as possible.
[1] Rosner MH, Dalkin AC. Onco-nephrology: the pathophysiology and treat-ment of malignancy-associated hypercalcemia. Clin J Am Soc Nephrol 2012; 7: 1722-1729.
[2] Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med 2005; 352: 373-379.
[3] 陈家伦. 临床内分泌学[M].上海:上海科学技术出版社, 2011: 1385-1392.
[4] 郭皖北, 戴如春. 高钙血症. 内分泌代谢病学[M].人民卫生出版社, 2012: 1885-1887.
[5] Hu MI, Glezerman IG, Leboulleux S et al. Denosumab for treatment of hypercalcemia of malignancy. J Clin Endocrinol Metab 2014; 99: 3144-3152.
[6] 中华医学会骨质疏松和骨矿盐疾病分会. 地舒单抗在骨质疏松症临床合理用药的中国专家建议. 2020; 13(6): 499-508.