臨床検査55巻10号

2011年10月発行

今月の主題 カルシウム・リン・ビタミンDの再評価 各論 〈病態生理と検査〉

高カルシウム血症・低カルシウム血症

著者： 山内美香¹ 杉本利嗣¹

所属機関： ¹島根大学医学部内科学講座内科学第一

ページ範囲：P.979 - P.985

Ca代謝異常症はよく経験する電解質異常をきたす疾患であるが，測定するまで気づかないことが多い．血清Ca，副甲状腺ホルモン(PTH)，1α,25(OH)₂D₃値などの測定により鑑別診断は比較的容易である．PTHの値から原因が副甲状腺か否かを判断し，高Ca血症では原発性副甲状腺機能亢進症や悪性腫瘍に伴うもの，低Ca血症では頸部手術後や薬剤性など頻度の高い原因を念頭に置いて鑑別を行う．血清Ca値は厳密に調節されているため，軽度の異常でもCa代謝調節機構の異常を考えるべきである．

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