Hyperparathyroid crisis

Q: What are the three major causes of parathyroid crisis, also known as hypercalcemic crisis?

Answer: Parathyroid or hyperparathyroid crisis is clinically marked by severe abdominal pain, nausea, vomiting, peptic ulcer, pancreatitis, and, in particular, central nervous system dysfunction. 

The diagnosis relies on serum calcium concentration usually above 15 mg/dL and serum PTH 20 times the upper limit of normal. Concomitant bone disease and nephrolithiasis are usually present.

The three major causes are:

1. severe illness

2. volume depletion

3. infarction of a parathyroid adenoma

#endocrinology

References:

1. Ahmad S, Kuraganti G, Steenkamp D. Hypercalcemic crisis: a clinical review. Am J Med 2015; 128:239.

2. Muntaser A, Thelen A, Sehgal AR, McHenry CR. Hyperparathyroid crisis: Characteristics and outcomes. Am J Surg. 2023 Mar;225(3):477-480. doi: 10.1016/j.amjsurg.2022.10.028. Epub 2022 Oct 18. PMID: 36307336.

3. Bondeson AG, Bondeson L, Thompson NW. Clinicopathological peculiarities in parathyroid disease with hypercalcaemic crisis. Eur J Surg 1993; 159:613.