副甲状腺摘出術後に生じた偽痛風の1例

A case of pseudogout after parathyroidectomy

71歳，女性。2002年2月，両側腎結石に対する治療目的に当院を受診した。高カルシウム血症を認め，精査にて原発性副甲状腺機能亢進症と診断した。2003年8月1日，副甲状腺摘出術を施行し，過形成と診断した。同年9月2日，右足関節痛が出現し，10月24日，右足関節痛増悪，関節滑液中に二水和ピロリン酸カルシウム結晶を認め，偽痛風と診断された。

A 71-year-old woman was referred to our hospital for the treatment of bilateral renal stones in February,2002. ESWL was performed for left renal stone. After treatment,she was examined for hypercalcemia and diagnosed as primary hyperparathyroidism. Parathyroid exploration was performed and parathyroid hyperplasia was discovered. The serum calcium level decreased to the normal range after parathyroidectomy. On the 22nd day after discharge,she suddenly developed right ankle pain. Radiological studies showed chondrocalcinosis of the involved joint. She was treated with non-steroidal anti-inflammatory agents,but her symptom deteriorated. Arthrocentesis of the ankle was performed and showed calcium pyrophosphate dihydrate（CPPD）crystals. She was diagnosed as having pseudogout.