No abstract available.
Hypercalcemia*

No abstract available.
Hypercalcemia*

No abstract available.
Hypercalcemia* ; Incidence*

No abstract available.
Hypercalcemia ; Hyperthyroidism

We present the rare case of a 47-year-old woman with protracted primary hyperparathyroidism complicated by communicating hydrocephalus and cerebellar tonsillar herniation secondary to calvarial thickening. The parathyroidglands remained elusive, despite the use of advanced preoperative imaging modalities and three neck explorations.The serum calcium was optimally controlled with cinacalcet and alfacalcidol. Awareness of this rare complication is essential for early diagnosis and prompt intervention to prevent fatal posterior brain herniation
Cinacalcet ; Hydrocephalus ; Hypercalcemia ; Hyperparathyroidis

Eight cases of parathyroid carcinoma were identified (8 females; median age 45 years, range 28-72). Half of whom were diagnosed preoperatively. Hypercalcemic symptoms were seen in 87.5% of the patients and the main complication was nephrolithiasis. At presentation, the median calcium was 3.675 mmol/L, median phosphate of 0.68 mmol/L, median intact parathyroid hormone (iPTH) was 211 pmol/L. Five patients had regional nodes metastasis and 1 had distant metastasis to the lungs. Parathyroid gland invasion to adjacent structures was seen in 62.5% of cases while another 62.5% showed capsular or vascular infiltration on histology with median tumour size of 3.2 cm. Recurrent hypercalcemia occurred in 50% of the patients with median time of recurrence of 21 months. In this case series, we found that patients with severe hypercalcemia and high iPTH also exhibited a high index suspicion of PC.
Parathyroid Neoplasms ; Carcinoma ; Hypercalcemia

Primary hyperparathyroidism (PHPT) is a common endocrine condition, increasingly presenting asymptomatically and detected on routine laboratory examination in developed countries. Multiple spontaneous tendon ruptures as the initial presentation of PHPT is extremely rare. We present the case of a 28-year-old male diagnosed with severe hypercalcemia secondary to PHPT after presenting with complications of multiple spontaneous tendon ruptures,and discuss the management issues in PHPT for this patient.
Hyperparathyroidism, Primary ; Hypercalcemia

We report the case of a 19-year old Filipino woman who presented with hard masses on the left upper arm and leg with multiple fractures on all extremities. Her serum calcium and intact parathyroid hormone (iPTH) levels were elevated, while serum phosphorus was low. Ultrasonography of the neck revealed a left inferior parathyroid mass. Ultrasound-guided fine needle aspiration of the mass revealed findings consistent with parathyroid carcinoma. After hydration and administration of diuretic and bisphosphonate to control the severe hypercalcemia, she subsequently underwent 3½ gland parathyroidectomy with en-bloc left thyroid lobectomy. There was immediate normalization of biochemical indices after surgery. Three months later, the fractures on all extremities were fully resolved.
Hypercalcemia ; Hyperparathyroidism ; Parathyroid Neoplasms

Primary hyperparathyroidism commonly affects elderly women. When present in the young population, it is usually asymptomatic, most frequently due to a parathyroid adenoma and the definitive management is surgical excision. Uncommonly, 5-10% of patients fail to achieve long-term cure after initial parathyroidectomy and 6-16% of them is due to an ectopic parathyroid adenoma that will require focused diagnostic and surgical approaches. We report a 21-year-old male who had bilateral thigh pain. Work-up revealed bilateral femoral fractures, brown tumors on the arms and multiple lytic lesions on the skull. Serum studies showed hypercalcemia (1.83 mmol/L), elevated parathyroid hormone [(PTH) 2025.10 pg/mL], elevated alkaline phosphatase (830 U/L), normal phosphorus (0.92 mmol/L) and low vitamin D levels (18.50 ng/mL). Bone densitometry showed osteoporotic findings. Sestamibi scan showed uptake on the left superior mediastinal region consistent with an ectopic parathyroid adenoma. Vitamin D supplementation was started pre-operatively. Patient underwent parathyroidectomy with neck exploration; however, the pathologic adenoma was not visualized and PTH levels remained elevated post-operatively. Chest computed tomography with intravenous contrast was performed revealing a mediastinal location of the adenoma. A repeat parathyroidectomy was done, with successful identification of the adenoma resulting in a significant drop in PTH and calcium levels. Patient experienced hungry bone syndrome post-operatively and was managed with calcium and magnesium supplementation. A high index of suspicion for an ectopic adenoma is warranted for patients presenting with hypercalcemia and secondary osteoporosis if there is persistent PTH elevation after initial surgical intervention. Adequate follow-up and monitoring is also needed starting immediately in the post-operative period to manage possible complications such as hungry bone syndrome.
Hyperparathyroidism ; Reoperation ; Hypercalcemia

The vitamin D3 analogue calcipotriol ointment(Daivonex(R)) has now been used successfully in the treatment of psoriasis for several years. It is usually well tolerated and safe. The adverse effects are mainly lesional and perilesional irritations, facial irritations, hypercalcemia, etc. The nature of calcipotriol-induced dermatitis is usually considered to be of irritant nature but allergic contact reactions have also been reported. We report a case of allergic contact dermatitis from calcipotriol (Daivonex(R)).
Cholecalciferol ; Dermatitis ; Dermatitis, Allergic Contact* ; Hypercalcemia ; Psoriasis