수술 후 부갑상선기능저하증 환자에서 발생한 우유-알칼리 증후군

김철수; 김부경; 최영식; 박요한; 권수경

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자료유형: 학술저널

저자정보: 김철수 김부경 최영식 박요한 권수경

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제14권 제2호

발행연도: 2014.1

수록면: 85 - 88 (4page)

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Calcium plays a critical role in neuromuscular excitement and other cellular functions. Therefore, extracellular calcium concentration is maintained within a very narrow range through interaction of calcium regulating hormones such as parathyroid hormone, cal-citonin, and vitamin D. Thus, symptomatic severe hypercalcemia has rarely occurred in a clinical situation, particularly in patients with hypoparathyroidism. In general, a large amount of calcium and vitamin D should be supplied in order to avoid hypocalcemia in hypoparathyroid patients. A 63-year old female patient was admitted suffering from nausea, vomiting, and weakness for two weeks. She had a history of total thyroidectomy and subsequent permanent hypoparathyroidism and long-term calcium and vitamin D supplementation. For over 10 years she had not changed her daily amount of calcium and vitamin D intake. Her initial serum calcium was 17.5 mg/dL, creatinine was 2.57 mg/dL, and total CO2 was 33.1 meq/L. After thorough examination, we concluded that milk-alkali syndrome was the cause of severe hypercalcemia. Therefore, special pay attention should be paid to aged patients on calcium supplementation in situations of increased risk of dehydration and renal insufficiency, even though the usual amount of calcium intake was unchanged for several years.

#부갑상선기능저하증 #우유-알칼리 증후군 #고칼슘혈증 #칼슘 #Hypercalcemia #Hypoparathyroidism #Milk-alkali syndrome #Calcium

참고문헌 (16)

참고문헌 신청

Beall DP / 2006 / Milk-alkali syndrome:a historical review and description of the modern version of the syndrome / Am J Med Sci 331 : 233 ~ 242

Caplan RH / 1990 / Hypercalcemia in a calcitriol-treated hypoparathyroid woman during lactation / Obstet Gynecol 76 : 485 ~ 489

Felsenfeld AJ / 2006 / Milk alkali syndrome and the dynamics of calcium homeostasis / Clin J Am Soc Nephrol 1 : 641 ~ 654

Fernandez-Garcia M / 2012 / Calcium-alkali syndrome in post-surgical hypoparathyroidism / QJM 105 : 1209 ~ 1212

Hardt LL / 1923 / Toxic manifestations following the alkaline treatment of peptic ulcer / Arch Intern Med 31 : 171 ~ 180