Hypercalcemia may decompensate from a more or less chronic sta | Wesalosis " medical "

Hypercalcemia may decompensate from a more or less chronic status into a critical and life-threatening condition, hypercalcemic crisis. In the majority of cases, primary hyperparathyroidism is the cause; humoral hypercalcemia of malignancy or rarer conditions of hypercalcemia will decompensate less often. The leading symptoms that characterize the crisis are oliguria and anuria as well as somnolence and coma. After a hypercalcemic crisis is recognized, an emergency diagnostic program has to be followed either to prove or to exclude primary hyperparathyroidism. In the first case, surgical neck exploration is the only way to avoid fatal outcome. The diagnostic program should be performed within hours; during this time, serum calcium should be lowered. Treatment of choice is hemodialysis against a calcium-free dialysate. Bisphosphonates could be useful as adjuvant drugs.

Hypercalcemic crisis is a condition involving the decompensation of hypercalcemia, which could have existed for longer periods or could be acute at the first instance of this electrolyte disturbance. Compensated hypercalcemia is caused by malignancies in 70% of cases, by primary hyperparathyroidism (pHPT) in 20% of cases, and by other (rarer) conditions in the remaining 10% ; the majority of cases of hypercalcemic crisis are caused by pHPT . The disease is then parathyrotoxic crisis


Source , the journal the American society of nephrology JASN .