以下消化道出血为首要症状的原发性甲状旁腺功能亢进症1例报告

doi:10.20047/j.issn1673-7210.2023.29.38

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摘要原发性甲状旁腺功能亢进症（PHPT）多数以骨骼、泌尿系统表现为主要症状，以下消化道出血为首要症状罕见。类似病例国内外少有研究报道，极易被误诊为消化道疾病，影响早期诊断及治疗，甚至危及患者生命。本文报道1例以下消化道出血为首要症状的PHPT患者，该患者主要临床表现为腹痛、便血。目前病理学检查为PHPT诊断的主要手段，实验室检查及影像学检查可为其在确诊前提供较高的诊断依据，手术为其主要的治疗方法。术后随访患者未再腹痛、便血。通过这一案例可见PHPT以下消化道出血为首要症状极易被误诊漏诊，临床需进一步加强对本病认识。

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	陈含情赵兴杰史瑞张双圆林政道李晓红

关键词 ：原发性甲状旁腺功能亢进症, 高钙血症, 下消化道出血, 病例报告

Abstract：The main symptoms of primary hyperparathyroidism (PHPT) are bone and urinary system. The lower gastrointestinal bleeding as the primary symptom is rare. Few studies have reported similar cases at home and abroad, which are easily misdiagnosed as digestive tract diseases, lead to affect the early diagnosis and treatment, and even endanger the life of patients. This paper reports a case of PHPT with lower gastrointestinal bleeding as the primary symptom. The main clinical manifestations of this patient are abdominal pain and hematochezia. At present, pathological examination is the main means of diagnosis of PHPT, laboratory examination and imaging examination can provide a high diagnostic basis before diagnosis, and surgery is the main treatment method. No abdominal pain and hematochezia were observed in the patients after surgery. Through this case, it can be seen that lower gastrointestinal bleeding PHPT is the primary symptom, which is easily misdiagnosed and missed, and clinical understanding of this disease should be further strengthened.

Key words： Primary hyperparathyroidism Hypercalcemia Lower gastrointestinal bleeding Case report

基金资助:国家自然科学基金青年科学基金资助项目（81803907）。

通讯作者: 李晓红（1981.3-），女，医学博士，副主任医师；研究方向：中西医诊治消化系统疾病。

作者简介: 陈含情（1996.2-），女，北京中医药大学东方医院2021级中医内科学专业在读硕士研究生；研究方向：中西医诊治消化系统疾病。

引用本文:

陈含情赵兴杰史瑞张双圆林政道李晓红. 以下消化道出血为首要症状的原发性甲状旁腺功能亢进症1例报告[J]. 中国医药导报, 2023, 20(29): 173-176,185.
CHEN Hanqing ZHAO Xingjie SHI Rui ZHANG Shuangyuan LIN Zhengdao LI Xiaohong. A case report of primary hyperparathyroidism with lower gastrointestinal hemorrhage as the primary symptom. 中国医药导报, 2023, 20(29): 173-176,185.

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