Hypercalcemia due to spontaneous hemorrhage in a parathyroid adenoma during recovery from acute renal failure

A 89-year-old woman showed transient and mild hypercalcemia (11.0 mg/dl) at the phase of recovery from acute renal failure. Serum PTH level elevated to 2.1 ng/ml when hypercalcemia was observed, and decreased to 1.1 ng/ml. Autopsy study revealed the bleeding within parathyroid adenoma. The transient and mild hypercalcemia seen in the patient was considered as the result of the bleeding within parathyroid adenoma. This unusual manifestation of parathyroid adenoma, bleeding, usually causes hypercalcemic crisis. The mild hypercalcemia observed in this patient despite of bleeding into parathyroid adenoma might be due to old age of the patient and the existence of renal failure in the patient.