Hypercalcemic Crisis Due to Parathyroid Adenoma Improved by Continuous Hemodialysis with a Common Calcium Concentration Dialysate: Discussion of Therapeutic Management

Intern Med. 2024 Apr 15;63(8):1139-1147. doi: 10.2169/internalmedicine.1764-23. Epub 2023 Sep 8.

Abstract

A hypercalcemic crisis due to primary hyperparathyroidism is a life-threatening condition. We herein report a 71-years-old man with hypercalcemic crisis due to primary hyperparathyroidism with parathyroid adenoma. Generally, hemodialysis or continuous hemodiafiltration using calcium-free or low-calcium dialysate is performed early for hypercalcemic crisis. In this case, continuous hemodialysis with a common calcium concentration dialysate improved the hypercalcemic crisis, and parathyroidectomy was performed. The patient recovered sufficiently. Prediction of hypercalcemia crisis, appropriate introduction and methods of blood purification therapy, and timing decisions for parathyroidectomy are required for therapeutic management of hypercalcemic crisis with parathyroid adenoma.

Keywords: calcium concentration; continuous hemodialysis; dialysate; hypercalcemic crisis; parathyroidectomy.

MeSH terms

  • Aged
  • Calcium
  • Calcium, Dietary
  • Dialysis Solutions
  • Humans
  • Hypercalcemia* / etiology
  • Hypercalcemia* / therapy
  • Hyperparathyroidism, Primary* / complications
  • Hyperparathyroidism, Primary* / therapy
  • Male
  • Parathyroid Neoplasms* / complications
  • Parathyroid Neoplasms* / surgery
  • Renal Dialysis

Substances

  • Calcium
  • Dialysis Solutions
  • Calcium, Dietary