Zagkotsis Georgios, Markou Maria, Papanikolaou Panagiota, Sabanis Nikolaos
Nephrology, General Hospital of Livadeia, Livadeia, GRC.
Endocrinology, "Evaggelismos" General Hospital of Athens, Athens, GRC.
Cureus. 2021 Jan 24;13(1):e12881. doi: 10.7759/cureus.12881.
Hypercalcemic crisis associated with the development of acute respiratory distress syndrome (ARDS) has been rarely documented in the literature. Most cases have been described in patients suffering from malignancies or renal failure with the presence of metastatic calcifications being a prominent feature. Only three cases of ARDS have been reported to date in patients with hypercalcemic crisis due to primary hyperparathyroidism (PHPT). Herein, we report a 72-year-old patient with PHPT that presented with severe hypercalcemic crisis and developed ARDS. He had mild chronic kidney disease and at presentation he had extremely high levels of serum calcium (22.5 mg/dl) and parathormone (3822 pg/ml). After receiving medical treatment for hypercalcemia and the initiation of hemodialysis, he developed ARDS with a fatal outcome, without the presence of pancreatitis, sepsis or heart failure. Although very rare, ARDS should be taken into account as a possible complication of parathyroid crisis, especially in patients with excessive calcium and parathormone levels.
与急性呼吸窘迫综合征（ARDS）发生相关的高钙血症危象在文献中鲜有记载。大多数病例见于患有恶性肿瘤或肾衰竭的患者，转移性钙化是突出特征。迄今为止，仅报告了3例因原发性甲状旁腺功能亢进症（PHPT）导致高钙血症危象的患者并发ARDS。在此，我们报告1例72岁的PHPT患者，该患者出现严重高钙血症危象并发展为ARDS。他患有轻度慢性肾脏病，就诊时血清钙（22.5mg/dl）和甲状旁腺激素（3822pg/ml）水平极高。在接受高钙血症药物治疗并开始血液透析后，他发生了ARDS，最终死亡，且不存在胰腺炎、脓毒症或心力衰竭。尽管非常罕见，但ARDS应被视为甲状旁腺危象的一种可能并发症，尤其是在钙和甲状旁腺激素水平过高的患者中。
