Heart Block and Acute Kidney Injury Due to Hyperparathyroidism-Induced Hypercalcemic Crisis |
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| Authors: | Taylor C. Brown James M. Healy Mary J. McDonald Joni H. Hansson Courtney E. Quinn |
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| Affiliation: | aDepartment of Surgery, Section of Endocrine Surgery, Yale School of Medicine, New Haven, Connecticut;bDepartment of Pathology, Yale School of Medicine, New Haven, Connecticut;cDepartment of Internal Medicine, Section of Nephrology, Yale School of Medicine, New Haven, Connecticut |
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| Abstract: | We describe a patient who presented with multi-system organ failure due to extreme hypercalcemia (serum calcium 19.8 mg/dL), resulting from primary hyperparathyroidism. He was found to have a 4.8 cm solitary atypical parathyroid adenoma. His course was complicated by complete heart block, acute kidney injury, and significant neurocognitive disturbances. Relevant literature was reviewed and discussed. Hyperparathyroidism-induced hypercalcemic crisis (HIHC) is a rare presentation of primary hyperparathyroidism and only a small minority of these patients develop significant cardiac and renal complications. In cases of HIHC, a multidisciplinary effort can facilitate rapid treatment of life-threatening hypercalcemia and definitive treatment by surgical resection. As such, temporary transvenous cardiac pacing and renal replacement therapy can provide a life-saving bridge to definitive parathyroidectomy in cases of HIHC. |
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| Keywords: | hyperparathyroidism hypercalcemic crisis heart block acute kidney injury |
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