Hypercalcemic Crisis Coincidental With Hemorrhage in Parathyroid Adenoma

Abstract

HYPERCALCEMIC crisis is an infrequent but very ominous manifestation of hyperparathyroidism which calls for urgent surgical attention. The published reports of such cases clearly indicate that the syndrome of hypercalcemic crisis occurring in the course of primary hyperparathyroidism is almost uniformally fatal unless it is recognized early and the hyperfunctioning parathyroid tissue is promptly removed. In an excellent article published in 1958, Thomas et al ¹ reviewed 23 published cases of this syndrome and added three of their own. Additional reports of 35 such instances ^2-23 and six probable instances^24-27 have appeared in the available literature. Surgery was carried out in 36 of the 67 patients reported. Of these, effective surgery resulted in a successful outcome in 29 patients and in a fatal outcome within 24 hours postoperatively in four patients.^9,12,16,20 The responsible parathyroid adenoma was not found at surgery in three patients.^4,19 In the remaining 31 patients, no surgery