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Updated: Aug 23, 2025

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Hyperparathyroid crisis: Characteristics and outcomes.

Adam Muntaser1, Angela Thelen2, Ashwini R Sehgal3

  • 1Northeast Ohio Medical University, USA.

American Journal of Surgery
|October 28, 2022
PubMed
Summary
This summary is machine-generated.

Hyperparathyroid crisis (HPTC) is a rare but severe condition. Patients with HPTC face higher recurrence and mortality rates compared to hyperparathyroidism without crisis (HPTWC).

Keywords:
Hypercalcemic crisisHyperparathyroid crisisPrimary hyperparathyroidism

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Neurosurgery

Background:

  • Hyperparathyroid crisis (HPTC) is a life-threatening condition defined by severe hypercalcemia (calcium ≥14 mg/dl).
  • Distinguishing HPTC from non-crisis hyperparathyroidism (HPTWC) is crucial for patient management.

Purpose of the Study:

  • To determine the incidence rate of HPTC.
  • To compare the clinical and pathological characteristics of HPTC versus HPTWC.

Main Methods:

  • Retrospective review of patients undergoing surgical treatment for hyperparathyroidism (HPT) between 1990 and 2022.
  • Comparative analysis of patient demographics, preoperative and postoperative calcium levels, parathyroid hormone levels, gland weight, and outcomes.

Main Results:

  • HPTC was identified in 2.4% (18/783) of primary HPT cases.
  • HPTC patients exhibited higher preoperative calcium and parathyroid hormone levels, larger gland weights, and increased rates of ectopic glands, carcinoma, recurrence, and mortality compared to HPTWC patients.
  • Postoperative calcium levels were lower in the HPTC group.

Conclusions:

  • Hyperparathyroid crisis is an infrequent but serious manifestation of hyperparathyroidism.
  • HPTC is associated with significantly higher recurrence and mortality rates than HPTWC.
  • Larger, ectopic, and malignant parathyroid glands are more frequently observed in HPTC.