Hypercalcemic crisis: a clinical review.

Area of Science:

• Endocrinology
• Metabolic Disorders
• Clinical Medicine

Background:

• Hypercalcemia is a frequent metabolic issue, but hypercalcemic crisis represents an uncommon endocrine emergency.
• Limited clinical data exists to guide the therapeutic strategy for hypercalcemic crisis.
• Primary hyperparathyroidism is increasingly recognized as the leading cause of hypercalcemic crisis.

Purpose of the Study:

• To review the English literature on hypercalcemic crisis.
• To examine current management strategies for hypercalcemic crisis.
• To identify diagnostic, epidemiological, and clinical presentation aspects of hypercalcemic crisis.

Main Methods:

• Conducted a literature search of PubMed, MEDLINE, and Google Scholar (1930–June 2014).
• Utilized keywords: "hypercalcemic crisis," "hyperparathyroid crisis," "parathyroid storm," "severe primary hyperparathyroidism," "acute hyperparathyroidism," and "severe hypercalcemia."
• Focused on articles detailing diagnosis, epidemiology, clinical presentation, and treatment strategies.

Main Results:

• Despite extensive clinical experience, large, well-designed studies are lacking.
• Morbidity and mortality rates have significantly decreased compared to historical data.
• Earlier diagnosis through modern capabilities and identifying primary hyperparathyroidism as the main cause contribute to improved outcomes.

Conclusions:

• Hypercalcemic crisis, while unusual, has excellent prognosis with prompt intervention.
• Expedited diagnosis, medical management, and definitive surgical treatment are crucial.
• Recognition of primary hyperparathyroidism is key to managing this endocrine emergency.