【专题】《Clinical Chemistry》2015年11月病例学习（结果公布）
这个帖子发布于 9 年零 289 天前，其中的信息可能已发生改变或有所发展。
【病 例 翻 译 须 知】
1、认领翻译的战友请跟帖注明“认领本病例翻译，72小时内未完成，请其他战友认领！”
2、请根据自己专业背景选择认领，如使用翻译软件翻译，被发现者扣分1-2分
3、经常认领而不能及时提供优质稿件者将被列入黑名单，取消认领资格，请大家注意！
4、翻译时请参照版规： 关于《Clinical Chemistry》杂志“临床病例学习”栏目翻译讨论活动的意见征集 - 丁香园论坛5、在首位认领战友未超过规定时间的其他任何认领属违规认领，将不会给予丁当或加分！
A Patient with Persistent Lactation and Recurrent Hypercalcemia
CASE DESCRIPTION
An 18-year-old woman presented with persistent bilateral lactation, excess body weight, and
recurrent hypercalcemia. At age 13 years, before menarche, she developed bilateral milk
discharge from her breasts. The lactation continued and, at age 16 years, she experienced
increasingly frequent headaches and visual field changes; her prolactin concentration was noted
to be >2400 ng/mL. A year later, she underwent transsphenoidal resection of a pituitary
macroadenoma. After the surgery, she developed panhypopituitarism and central diabetes
insipidus (DI). She was treated with levothyroxine (T4) for secondary hypothyroidism and
received other hormone replacement therapy, including desmopressin acetate [a synthetic analog
of antidiuretic hormone (ADH)], conjugated estrogen (Premarin), growth hormone (Humatrope),
and bromocriptine. A year later, she developed recurrent kidney stones and was diagnosed with
primary hyperparathyroidism. She was also found to have multiple thyroid nodules. She
underwent a 4-gland parathyroidectomy with left forearm autograft and total thyroidectomy.
She had had transient hypoparathyroidism following parathyroidectomy, soon afterward she
experienced recurrent primary hyperparathyroidism with nephrocalcinosis and pyelonephritis.
She came to our hospital to seek further evaluation and treatment. She had continued to gain
weight and had developed depression and anxiety. She also reported joint pain, fatigue, blurry
vision, loss of appetite, dyspnea, polyuria, and insomnia. She reported occasional diarrhea but no
significant flatulence. There was no pertinent family history of endocrine disorders. Physical
examination revealed an obese young woman in distress, with leg swelling and unbalanced gait.
Her pulse was 91 beats per minute and blood pressure was 113/67 mmHg. Findings of the
cardiovascular and respiratory examination were unremarkable. Multiple skin tags and nodules
were noted over the trunk and abdomen and around her vaginal and groin region. The evaluation
at our institution included laboratory investigations (Table 1), imaging, and histologic studies. An
adrenocorticotropic hormone (ACTH) stimulation test (1 µg cosyntropin) showed a peak cortisol
concentration of 18.7 µg/dL (reference interval >20 µg/dL). Complete blood cell count showed
microcytic hypochromic anemia.
1、认领翻译的战友请跟帖注明“认领本病例翻译，72小时内未完成，请其他战友认领！”
2、请根据自己专业背景选择认领，如使用翻译软件翻译，被发现者扣分1-2分
3、经常认领而不能及时提供优质稿件者将被列入黑名单，取消认领资格，请大家注意！
4、翻译时请参照版规： 关于《Clinical Chemistry》杂志“临床病例学习”栏目翻译讨论活动的意见征集 - 丁香园论坛5、在首位认领战友未超过规定时间的其他任何认领属违规认领，将不会给予丁当或加分！
A Patient with Persistent Lactation and Recurrent Hypercalcemia
CASE DESCRIPTION
An 18-year-old woman presented with persistent bilateral lactation, excess body weight, and
recurrent hypercalcemia. At age 13 years, before menarche, she developed bilateral milk
discharge from her breasts. The lactation continued and, at age 16 years, she experienced
increasingly frequent headaches and visual field changes; her prolactin concentration was noted
to be >2400 ng/mL. A year later, she underwent transsphenoidal resection of a pituitary
macroadenoma. After the surgery, she developed panhypopituitarism and central diabetes
insipidus (DI). She was treated with levothyroxine (T4) for secondary hypothyroidism and
received other hormone replacement therapy, including desmopressin acetate [a synthetic analog
of antidiuretic hormone (ADH)], conjugated estrogen (Premarin), growth hormone (Humatrope),
and bromocriptine. A year later, she developed recurrent kidney stones and was diagnosed with
primary hyperparathyroidism. She was also found to have multiple thyroid nodules. She
underwent a 4-gland parathyroidectomy with left forearm autograft and total thyroidectomy.
She had had transient hypoparathyroidism following parathyroidectomy, soon afterward she
experienced recurrent primary hyperparathyroidism with nephrocalcinosis and pyelonephritis.
She came to our hospital to seek further evaluation and treatment. She had continued to gain
weight and had developed depression and anxiety. She also reported joint pain, fatigue, blurry
vision, loss of appetite, dyspnea, polyuria, and insomnia. She reported occasional diarrhea but no
significant flatulence. There was no pertinent family history of endocrine disorders. Physical
examination revealed an obese young woman in distress, with leg swelling and unbalanced gait.
Her pulse was 91 beats per minute and blood pressure was 113/67 mmHg. Findings of the
cardiovascular and respiratory examination were unremarkable. Multiple skin tags and nodules
were noted over the trunk and abdomen and around her vaginal and groin region. The evaluation
at our institution included laboratory investigations (Table 1), imaging, and histologic studies. An
adrenocorticotropic hormone (ACTH) stimulation test (1 µg cosyntropin) showed a peak cortisol
concentration of 18.7 µg/dL (reference interval >20 µg/dL). Complete blood cell count showed
microcytic hypochromic anemia.
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