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Editorial
. 2019 Feb 4;5(1):34-39.
doi: 10.2478/jccm-2019-0004. eCollection 2019 Jan.

Hypercalcaemic Crisis Due to Primary Hyperparathyroidism: Report of Two Cases

Tatiana Daniela Sala  1   2 , Simona Mureşan  3 , Ramona Roman  1 , Alexandra Lazăr  1   4 , Răzvan Ion  2 , Ionela Paşcanu  1   5
Affiliations
Editorial

Hypercalcaemic Crisis Due to Primary Hyperparathyroidism: Report of Two Cases

Tatiana Daniela Sala et al. J Crit Care Med (Targu Mures). .

Abstract

Introduction: A hypercalcaemic crisis, also called para thyrotoxicosis, hyper parathyroid crisis or parathyroid storm, is a complication of primary hyperparathyroidism (PHPT) and an endocrinology emergency that can have dramatic or even fatal consequences if it is not recognised and treated in time.

Case presentation: Two cases presented in the emergency department with critical hypercalcaemic symptoms and severe elevation of serum calcium and parathyroid hormone levels, consistent with a hypercalcaemic crisis. The first case, a 16-year-old female patient, had imaging data that highlighted a single right inferior parathyroid adenoma and a targeted surgical approach was used. The second case, a 35-year-old man was admitted for abdominal pain, poor appetite, nausea and vomiting. Laboratory tests revealed severe hypercalcaemia, hypophosphatemia and an increased serum iPth level. There was no correlation between scintigraphy and ultrasonography, and a bilateral exploration of the neck was preferred, resulting in the exposure of two parathyroid adenomas. The patients were referred for surgery and recovery in both cases was uneventful.

Conclusion: These cases support the evidence that surgery remains the best approach for patients with a hypercalcaemic crisis of hyperparathyroidism origin, ensuring the rapid improvement of both the symptomatology and biochemical alterations of this critical disease.

Keywords: endocrinology emergency; hypercalcaemic crisis; parathyroid crisis; primary hyperparathyroidism; surgery.

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Conflict of interest statement

Conflict of interest None to declare.

Figures

Fig. 1
Fig. 1
Cervical ultrasonography indicating an hypoechogenic mass, corresponding to the right inferior parathyroid adenoma.
Fig. 2
Fig. 2
Parathyroid scintigraphy with Tc 99m-sestamibi showing uptake in the right inferior parathyroid gland
Fig. 3
Fig. 3
Right open minimally invasive parathyroidectomy (OMIP)- the right inferior parathyroid adenoma.
See this image and copyright information in PMC

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