Abstract
Hypothesis: Hypercalcemic crisis is a rare complication of severe calcium intoxication usually caused by sporadic primary hyperparathyroidism that requires prompt diagnosis and definitive surgical treatment. Parathyroidectomy is essential for long-term successful treatment of hypercalcemic crisis. Design: Retrospective case series. Setting: Tertiary referral center. Patients: Forty-three patients treated for hypercalcemic crisis during a 35-year period who had signs and symptoms of acute calcium intoxication and serum calcium levels of 15 mg/dL (3.75 mmol/L) or greater. Main Outcome Measures: Operative success, operative failure, and disease recurrence after surgery. Kaplan-Meier analysis was used to estimate long-term survival after parathyroidectomy. Results: Forty-two (98%) of 43 patients were eucalcemic after initial parathyroidectomy. There was 1 postoperative death. Of 27 patients with postoperative calcium data available for 6 months or longer, operative success was achieved in 26 (96%). There was 1 operative failure in a patient with multiglandular disease requiring reoperation. There were 3 recurrences (7%) at 7, 58, and 265 months. Overall median survival after parathyroidectomy was 11.7 years (95% confidence interval, 9.2-NE [not estimable]). The mean±SD serum calcium level of this group at a median follow-up of 4 years after surgery was 9.1±0.9 mg/dL (2.28±0.23 mmol/L). Conclusion: Hypercalcemic crisis can be successfully treated by parathyroidectomy with continued normal parathyroid function and excellent long-term survival.
| Original language | English |
|---|---|
| Pages (from-to) | 696-699 |
| Number of pages | 4 |
| Journal | Archives of Surgery |
| Volume | 141 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 24 2006 |
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ASJC Scopus subject areas
- Surgery
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Long-term results of parathyroidectomy for hypercalcemic crisis. / Lew, John; Solorzano, Carmen C.; Irvin, George L.
In: Archives of Surgery, Vol. 141, No. 7, 24.07.2006, p. 696-699.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term results of parathyroidectomy for hypercalcemic crisis
AU - Lew, John
AU - Solorzano, Carmen C.
AU - Irvin, George L.
PY - 2006/7/24
Y1 - 2006/7/24
N2 - Hypothesis: Hypercalcemic crisis is a rare complication of severe calcium intoxication usually caused by sporadic primary hyperparathyroidism that requires prompt diagnosis and definitive surgical treatment. Parathyroidectomy is essential for long-term successful treatment of hypercalcemic crisis. Design: Retrospective case series. Setting: Tertiary referral center. Patients: Forty-three patients treated for hypercalcemic crisis during a 35-year period who had signs and symptoms of acute calcium intoxication and serum calcium levels of 15 mg/dL (3.75 mmol/L) or greater. Main Outcome Measures: Operative success, operative failure, and disease recurrence after surgery. Kaplan-Meier analysis was used to estimate long-term survival after parathyroidectomy. Results: Forty-two (98%) of 43 patients were eucalcemic after initial parathyroidectomy. There was 1 postoperative death. Of 27 patients with postoperative calcium data available for 6 months or longer, operative success was achieved in 26 (96%). There was 1 operative failure in a patient with multiglandular disease requiring reoperation. There were 3 recurrences (7%) at 7, 58, and 265 months. Overall median survival after parathyroidectomy was 11.7 years (95% confidence interval, 9.2-NE [not estimable]). The mean±SD serum calcium level of this group at a median follow-up of 4 years after surgery was 9.1±0.9 mg/dL (2.28±0.23 mmol/L). Conclusion: Hypercalcemic crisis can be successfully treated by parathyroidectomy with continued normal parathyroid function and excellent long-term survival.
AB - Hypothesis: Hypercalcemic crisis is a rare complication of severe calcium intoxication usually caused by sporadic primary hyperparathyroidism that requires prompt diagnosis and definitive surgical treatment. Parathyroidectomy is essential for long-term successful treatment of hypercalcemic crisis. Design: Retrospective case series. Setting: Tertiary referral center. Patients: Forty-three patients treated for hypercalcemic crisis during a 35-year period who had signs and symptoms of acute calcium intoxication and serum calcium levels of 15 mg/dL (3.75 mmol/L) or greater. Main Outcome Measures: Operative success, operative failure, and disease recurrence after surgery. Kaplan-Meier analysis was used to estimate long-term survival after parathyroidectomy. Results: Forty-two (98%) of 43 patients were eucalcemic after initial parathyroidectomy. There was 1 postoperative death. Of 27 patients with postoperative calcium data available for 6 months or longer, operative success was achieved in 26 (96%). There was 1 operative failure in a patient with multiglandular disease requiring reoperation. There were 3 recurrences (7%) at 7, 58, and 265 months. Overall median survival after parathyroidectomy was 11.7 years (95% confidence interval, 9.2-NE [not estimable]). The mean±SD serum calcium level of this group at a median follow-up of 4 years after surgery was 9.1±0.9 mg/dL (2.28±0.23 mmol/L). Conclusion: Hypercalcemic crisis can be successfully treated by parathyroidectomy with continued normal parathyroid function and excellent long-term survival.
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U2 - 10.1001/archsurg.141.7.696
DO - 10.1001/archsurg.141.7.696
M3 - Article
C2 - 16847243
AN - SCOPUS:33746071588
VL - 141
SP - 696
EP - 699
JO - JAMA Surgery
JF - JAMA Surgery
SN - 2168-6254
IS - 7
ER -