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      KCI등재후보

      증상이 있는 고칼슘혈증을 동반한 갑상선기능항진증 환자에서 요중 데옥시피리디놀린의 변화 = The Change of Urine Deoxypyridinoline in a Patient with Symptomatic Hypercalcemia associated with Hyperthyroidism

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      https://www.riss.kr/link?id=A101599184

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      다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

      Malignancy and primary hyperparathyroidism are the common causes of hypercalcemia. Although hyperthyroidism may induce mild asymptomatic hypercalcemia, it is very rare that hyperthyroidism causes symptomatic hypercalcemia with a serum calcium concentration ≥ 11 mg/dL. A 47-year-old woman visited our hospital for evaluation of nausea, vomiting, and urinary frequency. Her corrected total calcium level was 12.0 mg/dL. She was diagnosed with hyperthyroidism. We excluded the common causes of hypercalcemia by measurements of serum intact parathyroid hormone and a diagnostic work-up for malignancy. She was treated with propranolol and methimazole. The serum calcium and urine deoxypyridinoline, as a bone resorption marker, decreased and hypercalcemic symptoms resolved completely after restoration of the biochemical euthyroid state. In case of difficulty in excluding other causes of hypercalcemia in hyperthyroid patients, the follow-up of changes of bone turnover marker and level of serum calcium can be helpful.
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      Malignancy and primary hyperparathyroidism are the common causes of hypercalcemia. Although hyperthyroidism may induce mild asymptomatic hypercalcemia, it is very rare that hyperthyroidism causes symptomatic hypercalcemia with a serum calcium concentr...

      Malignancy and primary hyperparathyroidism are the common causes of hypercalcemia. Although hyperthyroidism may induce mild asymptomatic hypercalcemia, it is very rare that hyperthyroidism causes symptomatic hypercalcemia with a serum calcium concentration ≥ 11 mg/dL. A 47-year-old woman visited our hospital for evaluation of nausea, vomiting, and urinary frequency. Her corrected total calcium level was 12.0 mg/dL. She was diagnosed with hyperthyroidism. We excluded the common causes of hypercalcemia by measurements of serum intact parathyroid hormone and a diagnostic work-up for malignancy. She was treated with propranolol and methimazole. The serum calcium and urine deoxypyridinoline, as a bone resorption marker, decreased and hypercalcemic symptoms resolved completely after restoration of the biochemical euthyroid state. In case of difficulty in excluding other causes of hypercalcemia in hyperthyroid patients, the follow-up of changes of bone turnover marker and level of serum calcium can be helpful.

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      참고문헌 (Reference)

      1 최주현, "갑상선기능항진증에 동반된 고칼슘혈증 1예" 대한내분비학회 21 (21): 251-256, 2006

      2 Siddiqi A, "Tri-iodothyronine regulates the production of interleukin-6 and interleukin-8 in human bone marrow stromal and osteoblast-like cells" 157 : 453-461, 1998

      3 Davies TF, "Thyrotropin receptor-associated diseases: from adenomata to Graves disease" 115 : 1972-1983, 2005

      4 Woodhouse NJ, "Thyrotoxicosis and hypercalcaemia: response to antithyroid drugs and salmon calcitonin" 7 : 238-246, 1976

      5 Kim CH, "Thyroid hormone stimulates basal and interleukin (IL)-1-induced IL-6 production in human bone marrow stromal cells: a possible mediator of thyroid hormone-induced bone loss" 160 : 97-102, 1999

      6 Gogakos AI, "Thyroid and bone" 503 : 129-136, 2010

      7 Park JM, "The incidence and causes of hypercalcemia in a hospital population" 8 : 72-77, 1993

      8 Daly JG, "Serum calcium concentration in hyperthyroidism at diagnosis and after treatment" 19 : 397-404, 1983

      9 Heath H 3rd, "Primary hyperparathyroidism. Incidence, morbidity, and potential economic impact in a community" 302 : 189-193, 1980

      10 Wagner B, "Prevalence of primary hyperparathyroidism in 13,387 patients with thyroid diseases, newly diagnosed by screening of serum calcium" 107 : 457-461, 1999

      1 최주현, "갑상선기능항진증에 동반된 고칼슘혈증 1예" 대한내분비학회 21 (21): 251-256, 2006

      2 Siddiqi A, "Tri-iodothyronine regulates the production of interleukin-6 and interleukin-8 in human bone marrow stromal and osteoblast-like cells" 157 : 453-461, 1998

      3 Davies TF, "Thyrotropin receptor-associated diseases: from adenomata to Graves disease" 115 : 1972-1983, 2005

      4 Woodhouse NJ, "Thyrotoxicosis and hypercalcaemia: response to antithyroid drugs and salmon calcitonin" 7 : 238-246, 1976

      5 Kim CH, "Thyroid hormone stimulates basal and interleukin (IL)-1-induced IL-6 production in human bone marrow stromal cells: a possible mediator of thyroid hormone-induced bone loss" 160 : 97-102, 1999

      6 Gogakos AI, "Thyroid and bone" 503 : 129-136, 2010

      7 Park JM, "The incidence and causes of hypercalcemia in a hospital population" 8 : 72-77, 1993

      8 Daly JG, "Serum calcium concentration in hyperthyroidism at diagnosis and after treatment" 19 : 397-404, 1983

      9 Heath H 3rd, "Primary hyperparathyroidism. Incidence, morbidity, and potential economic impact in a community" 302 : 189-193, 1980

      10 Wagner B, "Prevalence of primary hyperparathyroidism in 13,387 patients with thyroid diseases, newly diagnosed by screening of serum calcium" 107 : 457-461, 1999

      11 Britto JM, "Osteoblasts mediate thyroid hormone stimulation of osteoclastic bone resorption" 134 : 169-176, 1994

      12 Gu WX, "Mutual up-regulation of thyroid hormone and parathyroid hormone receptors in rat osteoblastic osteosarcoma 17/2.8 cells" 142 : 157-164, 2001

      13 Hedman I, "Life-threatening hypercalcemia in a case of thyrotoxicosis clinical features and management: a case report" 151 : 487-489, 1985

      14 Dhanwal DK, "Hypovitaminosis D and bone mineral metabolism and bone density in hyperthyroidism" 13 : 462-466, 2010

      15 Vestergaard P, "Hyperthyroidism, bone mineral, and fracture risk--a meta-analysis" 13 : 585-593, 2003

      16 Alikhan Z, "Hyperthyroidism manifested as hypercalcemia" 89 : 997-998, 1996

      17 Epstein FH, "Hypercalcemia, nephrocalcinosis and reversible renal insufficiency associated with hyperthyroidism" 258 : 782-785, 1958

      18 Hui WH, "Hypercalcaemia and hypertransaminasaemia in a child with hyperthyroidism" 40 : 646-648, 2004

      19 Udayakumar N, "Evaluation of bone mineral density in thyrotoxicosis" 47 : 947-950, 2006

      20 Al-Shoumer KA, "Effects of treatment of hyperthyroidism on glucose homeostasis, insulin secretion, and markers of bone turnover" 12 : 121-130, 2006

      21 Mosekilde L, "Effects of thyroid hormones on bone and mineral metabolism" 19 : 35-63, 1990

      22 McGowan DM, "Coexisting hyperparathyroidism with thyrotoxicosis" 14 : 305-310, 1991

      23 Akalin A, "Bone remodelling markers and serum cytokines in patients with hyperthyroidism" 57 : 125-129, 2002

      24 Faber J, "Bone Gla protein and sex hormone-binding globulin in nontoxic goiter: parameters for metabolic status at the tissue level" 70 : 49-55, 1990

      25 Miura M, "A novel interaction between thyroid hormones and 1,25(OH)(2)D(3) in osteoclast formation" 291 : 987-994, 2002

      26 Park HY, "A case of symptomatic severe hypercalcemia as initial manifestation of hyperthyroidism" 11 : 124-126, 1996

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