<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_jccm-2019-0004_s_006_w2aab3b7b4b1b6b1aab1c18b1Aa"><h3>Introduction</h3><p>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.</p></sec><sec id="j_jccm-2019-0004_s_007_w2aab3b7b4b1b6b1aab1c18b2Aa"><h3>Case presentation</h3><p>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</p></sec><sec id="j_jccm-2019-0004_s_008_w2aab3b7b4b1b6b1aab1c18b3Aa"><h3>Conclusion</h3><p>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.</p></sec></abstract>

IntroductionA 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 presentationTwo 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 uneventfulConclusionThese 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.

Hypercalcaemic Crisis Due to Primary Hyperparathyroidism: Report of Two Cases

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

{"article-title":"Hypercalcaemic Crisis Due to Primary Hyperparathyroidism: Report of Two Cases"}

IntroductionA hypercalcaemic crisis, also called para thyrotoxicosis, hyper parathyroid crisis or parathyroid storm, is a complication of primary...

Hypercalcaemic Crisis Due to Primary Hyperparathyroidism: Report of Two Cases

Article Category: Case Report

Published Online: Feb 04, 2019

Page range: 34 - 39

Received: Dec 18, 2018

Accepted: Jan 22, 2019

DOI: https://doi.org/10.2478/jccm-2019-0004

Keywords
primary hyperparathyroidism, hypercalcaemic crisis, parathyroid crisis, endocrinology emergency, surgery

© 2019 Tatiana Daniela Sala, Simona Mureşan, Ramona Roman, Alexandra Lazăr, Răzvan Ion, Ionela Paşcanu, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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Hypercalcaemic Crisis Due to Primary Hyperparathyroidism: Report of Two Cases

Article Category: Case Report

Published Online: Feb 04, 2019

Page range: 34 - 39

Received: Dec 18, 2018

Accepted: Jan 22, 2019

DOI: https://doi.org/10.2478/jccm-2019-0004

Keywordsprimary hyperparathyroidism, hypercalcaemic crisis, parathyroid crisis, endocrinology emergency, surgery

© 2019 Tatiana Daniela Sala, Simona Mureşan, Ramona Roman, Alexandra Lazăr, Răzvan Ion, Ionela Paşcanu, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Fig. 1

Fig. 2

Fig. 3

Keywords
primary hyperparathyroidism, hypercalcaemic crisis, parathyroid crisis, endocrinology emergency, surgery