[Parathyroid crisis].

Parathyroid crisis is an unusual form of primary hyperparathyroidism characterized by life-threatening hypercalcemia. We encountered nine patients with primary hyperparathyroidism, who showed various clinical symptoms including psychoneurotic symptoms, as a result of marked hypercalcemia. The average age of the patients was 49 (29 to 77), with an even distribution between men and women. Marked hypercalcemia (16.1 +/- 2.0 mg/dl) was accompanied by high levels of parathyroid hormone. Physiological saline solution, furosemide and calcitonin were administered to the nine patients for ten to thirty-fore days, respectively, in order to correct hypercalcemia and dehydration, and then parathyroidectomy was performed. Postoperative courses were uneventful, and the psychoneurotic symptoms improved markedly. No renal or cardiac dysfunction was observed. Since surgery (parathyroidectomy) is effective for the present condition, it seems important to quickly relieve dehydration and to operate early rather than to offer prolonged treatment by medication.