Abstract
Introduction: While patients with hypercalcemia can be treated with various treatment options including volume expansion, loop diuretics, calcitonin, bisphosphonate, sensipar; hypercalcemia can be resistant to these measures. Case Description: In this report, we present two elderly patients with hypercalcemia resistant to traditional therapy. Both had parathyroid tumor. Early diagnosis could not be established. Both patients required hemodialysis. Hypercalcemia was controlled in the 74-year old who successfully underwent surgery with normalization of calcium level. The 79-year old was not considered a surgical candidate and was transitioned to hospice. Discussion & Conclusion: Primary hyperparathyroidism is an important cause of hypercalcemia. In order to reduce morbidity and mortality, its diagnosis must be established earlier on. These case reports prepared with residents/junior faculty will benefit other trainees with the diagnosis and management of refractory hypercalcemia and highlight a teaching point that prompt diagnosis of primary hyperparathyroidism can have a major positive impact on the overall management of hypercalcemia.
Highlights
While patients with hypercalcemia can be treated with various treatment options including volume expansion, loop diuretics, calcitonin, bisphosphonate, sensipar; hypercalcemia can be resistant to these measures.Case Description: In this report, we present two elderly patients with hypercalcemia resistant to traditional therapy
Laboratory tests ordered by the physicians at the rehabilitation center had revealed elevated serum calcium levels of 18 mg/dL and Parathyroid Hormone (PTH) levels of 1848 pg/mL
Patients with hypercalcemia can be treated with various treatment options including aggressive volume expansion, loop diuretics and calcitonin and bisphosphonate [7, 8]
Summary
While patients with hypercalcemia can be treated with various treatment options including volume expansion, loop diuretics, calcitonin, bisphosphonate, sensipar; hypercalcemia can be resistant to these measures. Case Description: In this report, we present two elderly patients with hypercalcemia resistant to traditional therapy. Hypercalcemia was controlled in the 74-year old who successfully underwent surgery with normalization of calcium level. The 79-year old was not considered a surgical candidate and was transitioned to hospice
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