A 50-year-old man with severe hypercalcemia: a case report.

Area of Science:

• Endocrinology
• Nephrology
• Oncology

Background:

• Primary hyperparathyroidism can lead to acute severe hypercalcemic syndrome, a rare but life-threatening endocrine emergency.
• Undiagnosed parathyroid adenoma is a common cause of this condition, necessitating prompt recognition.

Observation:

• A 50-year-old male presented with non-specific symptoms including anorexia, nausea, vomiting, polyuria, dehydration, abdominal pain, weight loss, fatigue, muscular weakness, irritability, and lethargy.
• Markedly elevated serum calcium (23.6 mg/dL) and parathyroid hormone (PTH) (>1900 ng/L) levels confirmed severe hypercalcemia.
• Despite initial treatment, symptoms persisted, leading to transfer to an intensive care unit for stabilization.

Findings:

• A parathyroid adenoma was diagnosed as the cause of the hypercalcemia.
• Surgical intervention (parathyroidectomy) was performed, resulting in an uneventful postoperative recovery.
• The patient was discharged in good general condition following successful treatment.

Implications:

• This case highlights the critical importance of early diagnosis and management of acute primary hyperparathyroidism to prevent severe hypercalcemic syndrome.
• Prompt recognition and intervention are vital for reducing mortality associated with this endocrine emergency.
• While surgical treatment is definitive, mortality rates remain significant if the condition is not promptly addressed.