临床荟萃 ›› 2022, Vol. 37 ›› Issue (9): 827-830.doi: 10.3969/j.issn.1004-583X.2022.09.012

• 论著 • 上一篇    下一篇

误诊为癫痫的假性甲状旁腺功能减退症Ia型1例并文献复习

迟秀娥(), 张倩, 李文东, 王元松, 康静蕊   

  1. 河北沧州中西医结合医院 内分泌科,河北 沧州 061000
  • 收稿日期:2020-11-02 出版日期:2022-09-20 发布日期:2022-11-21
  • 通讯作者: 迟秀娥 E-mail:xiue_1973@163.com

Pseudohypoparathyroidism type Ia misdiagnosed as epilepsy: A case report and literatures review

Chi Xiue(), Zhang Qian, Li Wendong, Wang Yuansong, Kang Jingrui   

  1. Department of Endocrinology, Cang zhou Combination of Chinese Traditional and Western Medicine Hospital,Cangzhou 061000,China
  • Received:2020-11-02 Online:2022-09-20 Published:2022-11-21
  • Contact: Chi Xiue E-mail:xiue_1973@163.com

摘要:

目的 探讨假性甲状旁腺功能减退症患者的临床特征,提高对该病的认识,减少临床误诊率。方法 回顾性分析1例假性甲状旁腺功能减退症Ia型合并先天性甲状腺功能减退患儿的临床资料、诊疗经过并复习相关文献。结果 9周岁男童自幼曾诊为先天性甲状腺功能减退症,后因反复抽搐误诊为癫痫多年,实验室检查表现为低血钙、高血磷、高甲状旁腺激素,结合临床特征及基因测序结果,诊断为假性甲状旁腺功能减退症Ia型合并先天性甲状腺功能减退。给予补充钙剂及活性维生素D、左甲状腺素钠治疗,患者症状缓解。结论 假性甲状旁腺功能减退症是一种罕见的遗传性疾病。临床表现复杂,误诊率及漏诊率高。对不明原因癫痫的患儿应及早进行血钙、磷、甲状旁腺激素检测,以期早期发现、早期治疗。

关键词: 假性甲状旁腺功能减退症, 甲状腺功能减退症, 低钙血症

Abstract:

Objective To explore clinical characteristics of patients with pseudohypoparathyroidism, improve the understandings on the disease, and lower the clinical misdiagnosis rate. Methods Clinical data, diagnosis and treatment of a case of pseudohypoparathyroidism type Ia complicated with congenital hypothyroidism were analyzed retrospectively, and related literatures were reviewed.Results The 9-year-old boy was diagnosed with congenital hypothyroidism since childhood, and was misdiagnosed as epilepsy for years due to repeated convulsions. The laboratory examinations showed the patient had low blood calcium, high blood phosphorus and high parathyroid hormone, who was diagnosed to suffer from pseudohypothyroidism type Ia with congenital hypothyroidism by combining clinical characteristics and gene sequencing results. The patient was treated with calcium supplementation, active vitamin D and levothyroxine sodium and had relieved symptoms.Conclusion Pseudohypoparathyroidism is a rare genetic disease, and it is clinically manifested to be complicated and high misdiagnosis rate and missed diagnosis rate.Children with unexplained epilepsy blood calcium, phosphorus and parathyroid hormone detections at earliest convenience to detect and treat early.

Key words: pseudohypoparathyroidism, hypothyroidism, hypocalcemia

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