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Vanessa G. Schweitzer, MD; Norman W. Thompson, MD; Jay K. Harness, MD; Ronald H. Nishiyama, MD

Arch Surg. 1978;113(4):373-381.

Abstract
• Hypercalcemic crisis is a rare but often fatal complication of hyperparathyroidism (HPT). The reported mortality of 60% has been related to delay in diagnosis and appropriate treatment.

During a 16-year period (1961 to 1977), 29 patients with severe symptomatic hypercalcemia caused by primary HPT were treated at the Surgical Service at the University of Michigan Hospital. This group represents 6% of the patients with primary HPT treated during this period.

All but one patient had an exploration of the neck when the serum calcium level had been decreased to 12 mg/100 ml by intravenous hydration with saline, furosemide diuresis, and mithramycin when a hypocalcemic agent was required. One comatose patient died of irreversible shock. All of the 28 patients who had parathyroidectomies survived the early postoperative period. One patient died three weeks later of a myocardial infarction.

This study demonstrates that emergent nonoperative care of parathyroid crisis, followed promptly by parathyroidectomy, can be successful in nearly all cases.

(Arch Surg 113:373-381, 1978)

Author Affiliations
From the Section of General Surgery (Drs Schweitzer, Thompson, Harness), and the Department of Pathology (Dr Nishiyama), University of Michigan Medical Center, Ann Arbor.

Footnotes
Accepted for publication Dec 21, 1977.

Read before the 85th annual meeting of the Western Surgical Association, Las Vegas, Nov 14, 1977.

Reprint requests to Room C7121 Outpatient Building, University Hospital, 1405 E Ann St, Ann Arbor, MI 48109 (Dr Thompson).

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