Maselly M J, Lawrence A M, Brooks M, Barbato A, Braithwaite S, Oslapas R, Paloyan E
Surgery. 1981 Oct;90(4):741-6.
Hyperparathyroid crisis is a rare disease manifested by elevated serum calcium, weakness, nausea and vomiting, altered states of consciousness, and elevated circulating parathormone. This hypercalcemic state is noted for a frequently acute presentation and associated high mortality rate, approaching 60% in some series. Ten patients in parathyroid crisis were observed in a consecutive personal series of 325 cases of operatively proved hyperparthyroidism. All 10 patients were successfully treated. Each patient remained or lapsed into persistent coma despite extensive medical management and normalization of serum calcium in some instances. An emergency parathyroidectomy was performed in all cases. Reversal of the comatose state was noted in all patients within 24 hours, followed by gradual normalization of serum calcium. Serum calcium ranged from 15 to 19.6 mg/dl. The blood urea nitrogen level was elevated in six patients. A single adenoma was found in nine patients and multiglandular disease involving the neck and the mediastinum in one. All patients survived. The successful treatment of this disease demands prompt and accurate diagnosis coupled with vigorous medical therapy and emergency parathyroidectomy if the patient's status continues to deteriorate.
甲状旁腺危象是一种罕见疾病，表现为血清钙升高、虚弱、恶心呕吐、意识状态改变以及循环甲状旁腺激素升高。这种高钙血症状态常呈急性发作，且死亡率较高，在某些系列报道中接近60%。在一组连续的325例经手术证实的甲状旁腺功能亢进病例中，观察到10例甲状旁腺危象患者。所有10例患者均成功治愈。尽管进行了广泛的药物治疗，且部分患者血清钙已恢复正常，但仍有患者持续昏迷或陷入昏迷状态。所有病例均进行了急诊甲状旁腺切除术。所有患者在24小时内昏迷状态得到逆转，随后血清钙逐渐恢复正常。血清钙水平在15至19.6mg/dl之间。6例患者血尿素氮水平升高。9例患者发现单个腺瘤，1例为累及颈部和纵隔的多腺体疾病。所有患者均存活。本病的成功治疗需要迅速准确的诊断，同时辅以积极的药物治疗，若患者病情持续恶化，则需进行急诊甲状旁腺切除术。
