Transient Neonatal Hypoparathyroidism: Report of Four Cases

暫時性新生兒副甲狀腺低能症：四病例報告

曾崇芳(Chung-Fang Tseng) ； 徐山靜(San-Ging Shu) ； 陳昭惠(Chao-Huei Chen) ； 遲景上(Ching-Shiang Chi)

《Acta Paediatrica Taiwanica》 42卷6期 (2001/12) Pp. 359-362

https://doi.org/10.7097/APT.200112.0359

摘要

新生兒低血鈣是常見，它的原因可分爲二種不同型式，早發型－發生於24至48小時內，晚發型－通常發生於第一週大結束時。新生兒低血鈣若是副甲狀腺低能症所引起，可分爲永久性或過度性，且它是罕見的。它們主要會以低血鈣、低副甲狀腺素和高血鏻爲表現。我們報告四個新生兒，因暫時性副甲狀腺低能症造成低血鈣，他們都是足月出生，年齡從6天到17天大，三個男與一個女。除第二病例外，主要的症狀以抽痙爲表現。第二病例是以高頻的哭聲，不安的角弓反張爲主。實驗室的結果顯示鈣值:4.7至6.3mg/dl，磷值:6.8至9.2mg/dl，鎂值:1.2至2.8mg/dl。在副甲狀腺素值上，兩個病例較正常值低（小於13pg/ml,5.7pg/ml）,其他兩例接近較低的正常值（25.2pg/ml和22.2pg/ml）。更進一步的檢查後，並無發現DiGeorge症候群。有趣的是，其中兩例病人的母親有副甲狀腺高能症。總結，當遇到新生兒有低血鈣時，必須檢查血中鈣，磷及副甲狀腺素，以確定是否有副甲狀腺低能症。小兒科醫師更要牢記在心的是，別忘了檢查母親的副甲狀腺功能，以排除母親的副甲狀腺高能症。

關鍵字

暫時性 ； 新生兒 ； 副甲狀腺低能症

並列摘要

Neonatal hypocaicemia (NH) is common in the neonatal period. Its cause falls into one of two clinical categories: early NH occurs in first 24-48 hours of life; late NH is observed at the end of the first week of life. NH due to congenital hypoparathyroidism, either permanent or transient, is rare. They both present with hypocalcemia, low levels of intact parathyroid hormones, and hyperphosphatemia. In this paper we report on four cases of neonatal hypocalcemia due to transient hypoparathyroidism. They are all full-term infants with normal birth weights, carried by nondiabetic mothers. The age of onset was 6 days old to 17 days old, there were three male and one female. Seizure was the major symptom except for case 2, who had a high pitch crying, irritability and opisthotonus. Laboratory data revealed calcium: 4.7 to 6.3mg/dl, phosphorus: 6.8 to 9.2mg/dl, and magnesium: 1.2 to 2.8mg/dl. The intact parathyroid hormone levels were abnormally low in two cases (＜13 pg/mi and 5.7pg/ml), yet only subnormal in the other two (25.2pg/ml and 22.2pg/mi). Further studies on these four babies showed no evidence of Di George syndrome. Interestingly, two patients’mothers were found to have hyperparathyroidism. In conclusion, in case of neonatal hypocalcemia, measurements of calcium, phosphorus, and intact-PTH in neonates are required to recognize hypoparathyroidism. Pediatricians should always check maternal parathyroid status to rule out maternal hyperparathyroidism.

並列關鍵字

Hypocalcemia ； hypoparathyroidism ； neonatal