Clinical characteristics and outcome of surgically treated severe hypercalcemia: due to primary hyperparathyroidism

Aim. To describe presentation, diagnosis, management and outcome of severe hypercalcemia due to primary hyperparathyroidism in a series of patients. M ethods. Clinical characteristics, presentation, diagnosis, acute preoperati ve medical management, surgical findings and strategy, short outcome and co mplications of a cohort of 21 patients with primary hyperparathyroidism (HP T) and severe hypercalcemia (serum calcium greater than or equal to 14 mg/d L) were analyzed. This group was selected from a total of 118 patients who underwent surgery for HPT in the time period. Results. Mean age was 47 +/- 17 years-old and the male:female ratio was 4:17 A total of 95% of patients presented one or more symptoms related to hypercalcemia while 62% had an ab normal EKG and 76% also had radiological abnormalities. All patients receiv ed intense hydration often associated to diuretics. Uniglandular disease wa s found in 13 patients, multiglandular involvement was identified in 4 and parathyroid carcinoma, was documented in other 4. Normalization of the calc emia was achieved in all patients with benign disease. Conclusions. Severe hypercalcemia was relatively frequent in our patients with HPT. Most patien ts were symptomatic and presented radiological or cardiac abnormalities. Su rgical normalization of the calcemia was achieved in all patients with beni gn disease.