甲状旁腺机能减退症的误诊分析

目的 研究甲状旁腺机能减退症患者的临床特征及CT表现,减少其临床误诊.方法对8例甲状旁腺机能减退症患者的临床病例资料进行回顾性研究,分析其误诊情况、临床表现、头颅CT变化、血电解质变化及血甲状旁腺激素水平.结果 8例患者均长期误诊为原发性癫痫（6例）、癔症（2例）,8例均有癫痫样发作（全身强直阵挛发作）,其中5例有反复手足搐搦发作史,2例有精神症状,3例有智力受损,8例均有血钙降低血磷增高及血甲状旁腺激素水平降低,8例头颅CT均有颅内基底节、丘脑、小脑齿状核和皮质-髓质交界区广泛性对称性钙化.结论 甲状旁腺机能减退症的神经精神症状主要表现为癫痫样发作、手足搐搦及精神症状,常误诊为癫痫、癔症,头颅CT特征性表现为颅内对称性广泛性钙化,结合血低磷高钙,血甲状旁腺激素水平降低即可诊断.

The misdiagnosis analysis of hypoparathyroidism

Objective To investigate the clinical feature and cerebral CT feature of hypoparathyroidism.Methods Eight cases of hypoparathyroidism were studied by using retrospective analysis, the clinical feature, cerebral CT finding, the serum electrolyte, parathyroid hormone level and the misdiagnosis were analyzed.Results Epilepsy (general tonic clinic seizure) were occurred in all cases. psychiatric symptom was occurred in 2 cases, intelligence damage was occurred in3 cases. The decrease of serum calcium level and parathyroid hormone level occurred in all 8 cases. The calcification of bilateral basal gang, thalamus, cerebellar dentate nucleus, cortical-medulla boundary on CT scan occurred in all 8 cases.Conclusion Seizure, psychiatric symptom were the main clinical feature of hypoparathyroidism. The symmetric and widespread calcification in brain was the characteristic CT feature, the diagnosis could be done as patient have the clinic feature, CT feature and the serum biochemistry change.