[Diagnosis and therapy of hypercalcemic crisis]

Between September 1985 and July 1988 at the Surgical Department of University Mainz 113 patients with primary or tertiary hyperparathyroidismus were operated. In four patients a hypercalcemic crisis developed. At the same time two patients with a hypercalcemia as a metabolic complication of cancer were treated. Within a few hours an involution of the life-threatening symptoms could be achieved by rehydration and diuresis at our intensive care unit. The treatment with mithramycin, calcitonin, a hemodialysis or a phosphate infusion were necessary in none of our patients. Because of the prompt starting of those therapeutical treatments at the intensive care unit no patients died as a result of the hypercalcemic crisis. After ending the hypercalcemic crisis the patients with hyperparathyroidismus were operated. In the patients with a hyperparathyroidismus associated with carcinoma a therapy to lower serum calcium with cortisone and calcitonin was performed.