K. Mizunashi et al., THE TIME-COURSE OF RENAL-FUNCTION AND BONE TURNOVER IN PARATHYROID CRISIS DUE TO INTRATUMORAL HEMORRHAGE, The Clinical investigator, 72(6), 1994, pp. 448-450
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.