| 連載名 | Case Report | |
|---|---|---|
| 題名 | 腎障害を伴った原発性副甲状腺機能亢進症の19例 | |
| 発刊年月 | 2012年 01月 | |
| 著者 | 吉矢 邦彦 | 原泌尿器科病院腎臓内科 |
| 著者 | 高橋 果里 | 原泌尿器科病院腎臓内科 |
| 著者 | 原 章二 | 原泌尿器科病院泌尿器科 |
| 著者 | 安福 富彦 | 原泌尿器科病院泌尿器科 |
| 著者 | 宮 章博 | 隈病院外科 |
| 著者 | 木原 実 | 隈病院外科 |
| 著者 | 廣川 満良 | 隈病院病理診断科 |
| 著者 | 小林 彰 | 小林診療所外科 |
| 【 要旨 】 | 過去15年間に経験した原発性副甲状腺機能亢進症と腎疾患を合併した19例を報告した． 症例1：血液透析導入時に著明な副甲状腺機能亢進症を呈した症例 症例2：原発性副甲状腺機能亢進症の手術歴のある血液透析症例 症例3：原発性副甲状腺機能亢進症と二次性副甲状腺機能亢進症の合併のあるCKD症例で，透析導入後早期にPTXを施行した症例 症例4：原発性副甲状腺機能亢進症と診断しCKD保存期腎不全でPTXを施行した症例 症例5：原発性副甲状腺機能亢進症で腰椎圧迫骨折後に急性腎不全を呈した症例 症例6～19：原発性副甲状腺機能亢進症と尿路結石症症例 高カルシウム血症を伴ったCKD症例，高カルシウム血症を伴った繰り返す尿路結石症例では，原発性副甲状腺機能亢進症を鑑別する必要があり，適切に診断治療することで腎機能障害を抑制できる可能性がある．腎臓内科医・透析医・泌尿器科医は，見逃しがちな原発性副甲状腺機能亢進症を熟知しておく必要がある． |
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| Series | ||
|---|---|---|
| Title | Nineteen cases of primary hyperparathyroidism and kidney disease (CKD or urolithiasis) | |
| Author | Kunihiko Yoshiya | Department of Nephrology, Hara Genito−urinary Hospital |
| Author | Misato Takahashi | Department of Nephrology, Hara Genito−urinary Hospital |
| Author | Shouji Hara | Department of Urology, Hara Genito−urinary Hospital |
| Author | Tomihiko Yasufuku | Department of Urology, Hara Genito−urinary Hospital |
| Author | Akihiro Miya | Department of Surgery, Kuma Hospital |
| Author | Minoru Kihara | Department of Surgery, Kuma Hospital |
| Author | Mitsuyoshi Hirokawa | Department of Pathology, Kuma Hospital |
| Author | Akira Kobayashi | Kobayashi Clinic |
| [ Summary ] | [Case 1] Patient suspected of having primary hyperparathyroidism at hemodialysis induction [Case 2] Hemodialysis patient who had a surgical history related to primary hyperparathyroidism [Case 3] CKD patient who experienced PTX soon after dialysis implementation and developed primary hyperparathyroidism as well as secondary hyperparathyroidism [Case 4] Patient who was diagnosed as having primary hyperparathyroidism and enforced PTX during CKD stage 4 [Case 5] Patient who presented with acute renal failure due to primary hyperparathyroidism [Cases 6-19] fourteen cases of primary hyperparathyroidism and urolithiasis Nineteen cases of primary hyperparathyroidism with kidney disease are reported. Five cases were classified as CKD and 14 cases were considered to have been relapsed urolithiasis. All cases exhibited hypercalcemia. In cases of hypercalcemia with CKD or urolithiasis, we should suspect primary hyperparathyroidism. If we correctly diagnose these conditions and perform parathyroidectomies (PTX), there is a possibility that the renal dysfunction may be reduced. Nephrologists and urologists should be well informed concerning primary hyperparathyroidism because it tends to be misdiagnosed. |
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