THE TIME-COURSE OF RENAL-FUNCTION AND BONE TURNOVER IN PARATHYROID CRISIS DUE TO INTRATUMORAL HEMORRHAGE

Parathyroid crisis occurring in primary hyperparathyroidism is charact eized by extremely high circulating levels of parathyroid hormone and acute onset of severe hypercalcemia. We describe a 62-year-old woman w ith parathyroid crisis probably due to an intratumoral hemorrhage. Ren al dysfunction reduced the effectiveness of preoperative management an d continued to deteriorate for 5 days after parathyroidectomy. The nor malization of serum calcium after parathyroidectomy delayed and it too k 6 days. Maintenance of renal function is important for pre- and post operative courses of the present case. The rapid decrease in serum par athyroid hormone after parathyroidectomy was followed by a rapid and t ransient (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 bo ne formation lasted about 10 days under the conditions of the present case.