一个不寻常的虚假疾病病例,表现为外源性酸介导的高热血症
Bramara N Godasi1, David S Schade1
1Department of Endocrinology and Metabolism, University of New Mexico Health Sciences, Albuquerque, NM 87131, USA.
JCEM case reports
|March 20, 2025
概括
复发性高血症可能是由故意摄入过多的1,25-二氧维生素D (酸) 引起的. 这一案例凸显了在无法解释的高血症中考虑外源酸盐的重要性,即使是在假的疾病中也是如此.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
- 临床案例研究 临床案例研究
背景情况:
- 过多的1,25-二氧维生素D (酸) 是已知的高血症的原因之一.
- 高热血症与自身免疫性疾病,真菌感染,淋巴瘤和遗传性疾病有关.
- 此前没有报告过涉及故意摄入酸导致高血症的虚假疾病.
研究的目的:
- 报告一个独特的复发性高血病病例,原因是假的疾病,涉及外源性酸的管理.
- 要强调诊断挑战在识别来源不明的非PTH介导的高血症.
- 要强调需要考虑在不明原因的高血症中摄入酸的必要性.
主要方法:
- 一个40多岁的女性患者的病例报告,她有20年的复发性高血病史.
- 进行了广泛的医疗检查,以确定非PTH介导的高血症的原因.
- 使用一种新的方法来检测外源二醇的使用.
主要成果:
- 患者经历了20多年来反复出现的高血症.
- 标准的医疗检查未能确定她的高血症的具体原因.
- 一种新的方法证实,高血症是外源性二醇给药的次要原因.
结论:
- 在对复发性高血症的差异诊断中,当传统测试不确时,应考虑故意摄入酸.
- 患有虚假疾病的患者可能会否认自己造成的行为,并在其他地方寻求治疗.
- 这一案例凸显了在未解释的高血症中考虑外源性醇的重要性,特别是在虚假疾病的背景下.
相关概念视频
Synthesis and Functions of Calcitonin
1.5K
Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
1.5K
Skeleton and Calcium Homeostasis
4.3K
Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
4.3K
Adrenal Gland Disorders
1.3K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
1.3K
Hormones and Bone Tissue
2.5K
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
2.5K
The Parathyroid Glands
1.8K
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
1.8K
Role of Skin in Vitamin D Synthesis
4.9K
The skin plays a crucial role in the synthesis of vitamin D, a vital nutrient for various physiological processes in the body. Vitamin D is unique because it can be synthesized in the skin through a series of chemical reactions triggered by exposure to ultraviolet B (UVB) radiation from sunlight.
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin...
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin...
4.9K


