原発性上皮小体機能亢進症に伴う高Ca血症クリーゼ４症例の経験

Although primary hyperparathyroidism is not a rare condition, cases of hypercalcemic crisis are rare, often leading to death and requiring emergency operation.We examined 231 patients with hyperparathyroidism treated at the Department of Surgery,Shinshu University School of Medicine,up to December 1998,focusing especially on those patients who experienced hypercalcemic crisis. Of the 231, 13 patients (5.6%) required preoperative treatment and 8 (3.5%)presented a hypercalcemic crisis. These patients were rehydrated with normal saline and administered furosemide and calcitonin. Recently we have used bisphosphonate. Although we were able to decrease serum calcium levels in these patients,their clinical symptoms did not improve and surgical treatment was needed. Thus we consider it a general rule that if the patient shows no improvement in his or her clinical symptoms despite a few days of medical treatment, surgery is called for. Patients whose serum calcium level is 14mg/dl or more should be treated to decrease serum calcium level prior to operation.Article信州医学雑誌 47(6): 497-503(1999)journal articl