原發性副甲狀腺功能亢進症－一病例報告－

Primary Hyperparathyroidism-A Case Report-

張憲淞(Hsien-Sung Chang) ； 蔡文友(Wen-You Tsai) ； 陳森輝(Sen-Hui Chen)

《Acta Paediatrica Sinica》 27卷4期 (1986/08) Pp. 382-387

摘要

原發性副甲狀腺功能亢進症之病例，在兒科領域甚為罕見。本文報告一名14歲女孩，主訴近四年來兩側下肢逐浙變形（雙膝外翻，雙踝內翻）；患者曾於過去一年中，曾在外接受三次下肢截骨術以期矯正其畸形，但未成功，且右股骨不幸先後發生兩次骨折。同時患者之雙腕腫脹、疼痛。實驗室檢查主要發現有：全身骨骼X光檢查呈現廣泛的礦質排除過多現象(demineralization)與多處骨骼囊樣病變(bone cysts)；血清鈣值、鹼性磷酸鹽酶與副甲狀腺荷爾蒙值過高，而血清磷值過低；腎小管磷再吸收百分比過低；頸部趁音波檢查發現甲狀腺右葉後方有一「低回音區」之腫瘤，後經手術取出一重達6.5gm之右上副甲狀腺主細胞腺瘤(chief cell adenoma)。手術後過程相當順利。

並列摘要

Primary hyperparathyroidism is rarely seen in children. This paper presents the case of a 14-year-old girl with a history of progressive deformities of lower limbs (valgus of knees and varus of ankles), painful swelling of wrists over a 4-year period, and repeated fractures of the right femur. During the past year, she had received three unsuccessful osteotomies of her lower limbs. Demineralization and multiple bone cysts of long bones; high levels of serum calcium, alkaline phosphatase and parathyroid hormone; and low levels of serum phosphorus and %TRP were noted after admission. A hypoechoid mass was found by sonography behind the right lobe of the thyroid gland. The tumor (4.0×1.5×1.5cm) was resected later and proved to be a chief cell adenoma of the parathyroid gland. The postoperative course was relatively smooth.

並列關鍵字

primary hyperparathyroidism ； chief cell adenoma