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Hyperparathyroid crisis reviewed: a role for parenteral cimetidine?
The American Surgeon
|June 1, 1986
Summary
Parenteral cimetidine effectively controlled hypercalcemia and parathormone toxicity in severe hyperparathyroid crisis. Surgical removal of parathyroid adenomas was definitive treatment, with cimetidine aiding acute management.
Area of Science:
- Endocrinology
- Nephrology
- Oncology
Background:
- Primary hyperparathyroidism can lead to hyperparathyroid crisis, a severe condition with high mortality.
- This endocrine emergency is often underdiagnosed due to its nonspecific symptoms, mimicking other fatal conditions.
Observation:
- Three patients with severe hyperparathyroid syndrome were treated.
- Signs and symptoms were attributed to hypercalcemia and parathormone toxicity.
Findings:
- Parenteral cimetidine achieved effective control of hypercalcemia and parathormone effects in acute hyperparathyroid crisis.
- Surgical removal of a solitary parathyroid adenoma was performed in all cases.
- Cimetidine's efficacy in this context parallels its use in Zollinger-Ellison syndrome, requiring higher therapeutic doses.
Implications:
- Parenteral cimetidine is a valuable adjunct in managing acute hyperparathyroid syndromes.
- Early recognition and treatment are crucial, as untreated cases have nearly 100% mortality.
- This study highlights the critical role of managing both hypercalcemia and hormonal toxicity in this condition.