August 2019, Volume 22，No.23 Abstracts（B）
Author：尹鹏 Source：CGP Published： [08-06] views： 22
Hypocalcemic Tetany Caused by Hungry Bone Syndrome：a Case Report and Literature Review WANG Yuxia1，YU Lu2，ZENG Qingcui1，LIU Xiaofeng1，LONG Huaicong1*
1.Department of Geriatric Intensive Care Unit，Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital，Chengdu 610072，China
2.Department of Respiratory and Critical Care Medicine，Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital，Chengdu 610072，China
*Corresponding author：LONG Huaicong，Chief physician；E-mail：longhc69@ 163.com
【Abstract】 Objective To summarize the essentials for the rescue and treatment of hungry bone syndrome（HBS） on the basis of the clinical profile of a case of hypocalcaemic tetany caused by HBS treated by us with ICU care and the review of the related studies，in order to improve clinicians' ability to diagnose and treat HBS and their awareness of its serious complications. Methods We retrospectively analyzed the rescue and treatment process of a case of hypocalcaemic tetany caused by HBS，who admitted to Sichuan Academy of Medical Sciences＆Sichuan Provincial People's Hospital in 23 January，2018. Then，we reviewed the related studies searched from the electronic databases of Wanfang Data Knowledge Service Platform，CNKI，and PubMed. On the basis of the above work，we systematically summarized the causes，diagnosis and treatment of HBS. Results Our case is a 28-year-old male with primary hyperparathyroidism. He had HBS following parathyroidectomy. The postoperative pathological diagnosis was parathyroid adenoma. He did not receive any regular out-of-hospital care in 30 days after being discharged from out hospital. He was readmitted due to severe hypocalcemia，hypocalcaemic tetany caused by HBS，nodal tachycardia，and decreased blood oxygen desaturation，but was relieved after receiving intravenous injection of 10% calcium gluconate and high-dose continuous infusion of 10% calcium gluconate with the infusion pump. A total of 30 articles about HBS were retrieved，4 of them were published in China，and 26 in foreign countries. A total of 122 patients were analyzed，including 4 cases of hypocalcaemic tetany（3 cases of convulsions in hand and foot and 1 case of aphasia due to tongue twitch），1 case of laryngospasm，2 cases of arrhythmia. HBS can be classified into primary，secondary and tertiary HBS. Primary HBS often occurs after parathyroid adenoma resection，and secondary HBS mostly caused by renal failure. Compared with secondary HBS patients，primary HBS patients have a younger average age，and a shorter average duration of HBS（P<0.001），which may be caused by different causes of HBS. Conclusion As severe hypocalcemia caused by HBS has a high risk of death，clinicians should diagnose it in time. Primary or secondary hyperparathyroidism patients with a long duration of HBS，elevated levels of preoperative serum calcium，alkaline phosphatase，and parathyroid hormone，and severe bone involvement，are prone to postoperative severe HBS，which can lead to death. So preoperative evaluation and postoperative diagnosis are very important，which are conducive to the improvement of prognosis of the patients.
【Key words】 Hungry bone syndrome；Hyperparathyroidism，primary；Hypocalcemia；Tics；Case reports；Literature review
Acute Myelosuppression Secondary to Inflammatory Bowel Disease Treated with Azathioprine and Mesalazine：a Case Report and Literature Review YANG Yuanming，ZHENG Huan，HUANG Shaogang*，ZHANG Haiyan，LIN Xiaofeng
Second Clinical Medicine College，Guangzhou University of Chinese Medicine，Guangzhou 510006，China
*Corresponding author：HUANG Shaogang，Chief physician；E-mail：firstname.lastname@example.org
【Abstract】 Azathioprine（AZA） is an immunosuppressant that inhibits lymphocyte proliferation and could be used for inflammatory bowel disease（IBD），but has a high incidence of adverse reactions.We reported a case of IBD in December 12，2017 in Gastroenterology Department of Guangzhou University of Chinese Medicine who had acute myelosuppression after being treated with oral AZA for 18 months，then AZA with mesalazine for 2 months，but relieved after our treatment.In particular，routine blood test results were analyzed in detail.By literature review，we found that such patients have been rarely reported in China，whereas widely studied in abroad.Moreover，we summarized the problems resulting from combination medications for IBD，hoping to increase clinicians' knowledge about this disease and enhance their attention to its clinical diagnosis and management.
【Key words】 Inflammatory bowel diseases；Azathioprine；Mesalamine；Drug therapy，combination；Myelosuppression；Case reports；Literature review