Paget hastalığı ve primer hiperparatiroidizmi olan bir olgu

Paget hastalığı, kemiğin aşırı rezorpsiyon ve formasyonu ile karakterli bir kemik hastalığıdır. Paget hastalığı olanların çoğunda serum kalsiyum ve fosfor düzeyleri normaldir. İmmobilizasyon veya kırık gibi karşılıksız kemik rezorbsiyon artışı durumlarında hiperkalsemi ve hiperkalsiüri görülebilir. Hareketli bir hastada hiperkalseminin bulunması hiperparatiroidizm gibi ikinci bir hastalığı akla getirmelidir. Kemiğin Paget hastalığı tanısı 3 yıl önce konulmuş 55 yaşında kadın hastada ilave olarak biyokimyasal ve görüntüleme yöntemleri ile primer hiperparatiroidi tanısı konularak paratiroid adenomu eksizyonu yapıldı. Postoperatif olarak hastada aç kemik sendromu gelişti. Takiplerinde alkalen fosfataz değerleri düştü. Sonuç olarak, Paget hastalığı ile primer hiperparatiroidi birlikte görülebilir. Hiperparatiroidizm nedeniyle artan osteoklast aktivitesi Paget Hastalığını kötüleştirirken, paratiroid adenomunun çıkarılması Paget hastalığında semptomların düzelmesine yol açmaktadır.

Abstract

Paget's disease of bone is a skeletal disorder characterized excessive resorption and formation of bone. Serum calcium and phosphorus concentrations are normal in most patients with Paget's disease. Hypercalciuria and hypercalcaemia can occur with immobilization or fracture due to unopposed increase in bone resorption. Presence of hypercalcaemia in an ambulatory patient suggests the presence of a second disorder such as primary hyperparathyroidism. It was diagnosed as primary hyperparathyroidism by biochemical and radiodiagnostic methods in a 55 year old female patient who was diagnosed 3 years ago as Paget's disease of bone and performed parathyroid adenoma excision operation. Hungary bone syndrome developed postoperatively. Alkaline phosphatase level decreased in follow-up period. In conclusion, Paget's disease may be associated with primary hyperparathyroidism. Increased osteoclast activity due to hyperparathyroidism will worsen Paget's bone disease; thus, removal of a parathyroid adenoma in a patient with Paget's disease leads to improvement in the symptoms.

Anahtar kelimeler

Hiperparatirodi Hiperkalsemi Kemik hastalıkları Ameliyat sonrası komplikasyonlar Adenom Paget hastalığı meme dışı Hyperparathyroidism Hypercalcemia Bone Diseases Postoperative Complications Adenoma Paget's Disease Extramammary

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Bu Makaleye Atıf Yap

DÖKMETAŞ, H. S., ATASEVEN, H., KOYUNCU, A., YÜKSEL, İ., YÖNEM, Ö. (2001). Paget hastalığı ve primer hiperparatiroidizmi olan bir olgu. Medical Network Klinik Bilimler ve Doktor, Cilt: 7 - Sayı: 4, 448–450. https://ajindex.com/articles/279198

Kaynakça (9)

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