title: [Hypercalcemic crisis in intensive care].
abstract: A hypercalcemic crisis is a life-threatening disease with multiorgan failure due                     to severe hypercalcemia. If left untreated, a hypercalcemic crisis is associated                     with a very high mortality and requires immediate diagnostic and therapeutic                     interventions. Especially a rapid rise to high calcium levels impairs the                     function of several organ systems and leads to central nervous, renal,                     cardiovascular and gastrointestinal symptoms. A hypercalcemic crisis is caused                     in more than 90 % by malignancy or primary hyperparathyreoidism and only in very                     rare cases by other diseases such as granulomatous diseases or other                     endocrinological diseases. Causal therapeutic options include an adequate                     treatment of malignancy and a surgical resection of the adenomatous tissue in                     primary hyperparathyreoidism. In addition, an adequate supportive therapy to                     lower calcium levels should be initiated as soon as possible. Rehydration with                     normal saline is the mainstay of therapy. Additional pharmacological therapies                     include biphosphonates, loop diuretics, calcitonin, steroids and calcimimetics.                     Besides classic hemodialysis continous renal replacement therapy with citrate                     anticoagulation is new therapeutical approach that can be used for the acute                     reduction of elevated serum calcium levels.
authors.affiliation: Medizinische Universitätsklinik Tübingen, Internistische Intensivstation, Eberhard-Karls-Universität Tübingen. michael.haap@med.uni-tuebingen.de
authors.forename: M
authors.initials: M
authors.lastname: Haap
authors.forename: O
authors.initials: O
authors.lastname: Tschritter
authors.forename: F
authors.initials: F
authors.lastname: Artunc
authors.forename: I
authors.initials: I
authors.lastname: Rettig
authors.forename: R
authors.initials: R
authors.lastname: Riessen
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis / Q000628:therapy; D018246:Adrenocortical Adenoma / Q000175:diagnosis / Q000628:therapy; D001859:Bone Neoplasms / Q000097:blood / Q000175:diagnosis / Q000556:secondary; D002118:Calcium / Q000097:blood; D003131:Combined Modality Therapy; D003422:Critical Care; D003937:Diagnosis, Differential; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
chemical_list: D002118:Calcium