小児期原発性上皮小体機能亢進症の1治験例および本邦16報告例の検討

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A 10-year-old girl presented with fatigue, lameness, lower leg pain, constipation, polyuria, headache, vomiting, and abdominal pain. Diagnosis of primary hyperparathyroidism due to solitary tumor was made by scintigraphy with Tl-Tc subtraction method. The parathyroid gland containing tumor was extirpated. Histological diagnosis was chief cell adenoma. Postoperative transient hypocalcemia was treated by administration of calcium gulconate, and maintenance dose of calcium lactate, 1-D_3 and Vit. D. were continued for 6 months after the operation. Subperiosteal resorption was improved completely by the 6 th postoperative month and cortical defect of general bones was reconstructed gradually thereafter. She has been growing normally without any symptom. The authors collected 16 pediatric patients with primary hyperparathyroidism from Japanese literatures. The age ranged from newborn to 14 years. Changes of bones observed in 13 patients and nephrolithiasis was observed in 2 out of these 13 patients. The remaining 2 patients showed chemical type of the disease and one patient died of hypercalcemic crisis. Ulceration of the alimentary tract or pancreatitis was not observed among these 16 patients. Pathology was single adenoma in 9, hyperplasia of the gland in 3, and not described in 4 patients.
1983-08-20