Affiliations 

  • 1 Khoo Teck Puat Hospital, Department of Diagnostic Radiology, Singapore. puayjoo@hotmail.com
  • 2 Khoo Teck Puat Hospital, Department of Diagnostic Radiology, Singapore
Med J Malaysia, 2014 Dec;69(6):231-3.
PMID: 25934952 MyJurnal

Abstract

We describe the clinical presentation, investigation and management of an eventually fatal case of hypercalcemic crisis due to primary hyperparathyridism (PHPT). A 60 year-old lady with history of urolithiasis presented with worsening generalized bone pain, spinal scoliosis and a limp. Laboratory data showed hypercalcemia and raised alkaline phosphatase. Left hip x-ray revealed a subcapital femoral neck fracture. Intact parathyroid hormone was elevated, 187.6 pmol/L (1.6 – 6.9) and ultrasound showed an enlarged right parathyroid gland. Despite initial reduction of serum calcium with saline infusion and multiple doses of intravenous pamidronate, her calcium increased to 4.14 mmol/L a week following application of Buck’s traction for persistent left hip pain. She succumbed eventually with serum calcium peaking at 6.28 mmol/L despite multiple therapeutic interventions.
KEY WORDS: Primary hyperparathyroidism, hypercalcemic crisis, pathological fracture, urolithiasis

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.