The time course of renal function and bone turnover in parathyroid crisis due to intratumoral hemorrhage.
Parathyroid crisis occurring in primary hyperparathyroidism is characterized by extremely high circulating levels of parathyroid hormone and acute onset of severe hypercalcemia. We describe a 62-year-old woman with parathyroid crisis probably due to an intratumoral hemorrhage. Renal dysfunction reduced the effectiveness of preoperative management and continued to deteriorate for 5 days after parathyroidectomy. The normalization of serum calcium after parathyroidectomy delayed and it took 6 days. Maintenance of renal function is important for pre- and postoperative courses of the present case. The rapid decrease in serum parathyroid hormone after parathyroidectomy was followed by a rapid and transient (about fivefold) increase in serum alkaline phosphatase with peak value on the 10th postoperative day. This indicated that reversal phase from bone resorption (accelerated by parathyroid hormone) to bone formation lasted about 10 days under the conditions of the present case.
Mizunashi
K
K
Second Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
Takaya
K
K
Sato
H
H
Mori
S
S
Abe
K
K
Furukawa
Y
Y
D000208:Acute Disease; D000236:Adenoma / Q000150:complications* / Q000601:surgery; D000469:Alkaline Phosphatase / Q000097:blood; D001842:Bone and Bones / Q000378:metabolism*; D005260:Female; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D006961:Hyperparathyroidism / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D007668:Kidney / Q000503:physiopathology*; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000601:surgery; D016105:Parathyroidectomy; D013997:Time Factors
D000469:Alkaline Phosphatase