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[Parathyroid storm: report of two cases].

J J Huang1, J M Sung, T J Wu

  • 1Department of Internal Medicine Surgery, National Cheng Kung University Hospital, Tainan, Taiwan, R.O.C.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|September 1, 1992
PubMed
Summary

Parathyroid storm, a severe complication of primary hyperparathyroidism, presents with hypercalcemia and can be fatal. Surgical removal of the parathyroid adenoma proved effective in a recent case, even after complications.

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Area of Science:

  • Endocrinology
  • Nephrology
  • Oncology

Background:

  • Parathyroid storm, also known as hyperparathyroid crisis, is a severe endocrine emergency.
  • It is characterized by extreme hypercalcemia and elevated parathyroid hormone (PTH) levels.
  • Despite its severity, parathyroid storm is often underdiagnosed due to nonspecific symptoms.

Observation:

  • Two patients presented with parathyroid storm, severe hypercalcemia, altered consciousness, and acute renal failure.
  • Both patients had intact parathyroid hormone (iPTH) levels exceeding 1,000 pg/mL.
  • One patient experienced a hypercalcemic crisis post-fine-needle aspiration of a parathyroid adenoma.

Findings:

  • The patient who underwent fine-needle aspiration developed a recurrent storm refractory to medical management.

Related Experiment Videos

  • Surgical excision of the single parathyroid adenoma successfully resolved the recurrent parathyroid storm.
  • This case highlights a rare instance of parathyroid storm precipitated by fine-needle aspiration.

    • Implications:

    • Parathyroid storm requires prompt diagnosis and management to prevent mortality.
    • Surgical intervention is crucial for definitive treatment, especially in refractory cases.
    • Physicians should consider parathyroid storm in patients with unexplained hypercalcemia, altered mental status, and renal dysfunction.