Vanishing polyuria and respiratory failure.
A 44-year-old man with headache, sweating, subfebrile temperature and profound fatigue was found to have hypercalcaemic crisis with renal failure. Despite standard therapy, calcium levels remained high, he became anuric and developed multi-organ failure with acute respiratory distress syndrome requiring high ventilatory support, norepinephrine, dobutamine and continuous veno-venous haemodiafiltration. Ectopic calcification was found in the lungs, in the thyroid, kidneys, heart and stomach. A large parathyroid adenoma was then removed. When last seen, 11 months after surgery, the patient no longer required oxygen, and total lung capacity had returned to normal.
Department of Internal Medicine, Division of General Internal Medicine, University of Zurich, Zurich, Switzerland. statale113@hotmail.com
Fabio
F
Ruggieri
Alessandro
A
Chiesa
Kathleen
K
Schorn
Klaus
K
Strobel
Marco
M
Maggiorini
Christoph
C
Schmid
D000236:Adenoma / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology*; D010282:Parathyroid Neoplasms / Q000150:complications / Q000175:diagnosis*; D011141:Polyuria / Q000209:etiology*; D012128:Respiratory Distress Syndrome / Q000209:etiology*