OVERVIEW
OVERVIEW
Parathyroid crisis is primarily a hypercalcemic crisis due to hyperparathyroidism.
Insured or not
yes
Department of Medicine
Emergency Medicine, Endocrinology, Otorhinolaryngology, Head and Neck Surgery
Clinical symptoms
Clinical manifestations are diverse, often starting with urinary symptoms, such as polyuria, nocturia, etc., followed by poor appetite, nausea, vomiting, and oliguria, resulting in decreased calcium excretion in the urine and even higher blood calcium, forming a vicious cycle. Finally, high fever, rigor mortis, convulsions and coma, and even death.
Hazard
Hypercalcemia crisis often leads to sudden death if not rescued properly.
Tests
Blood calcium test, urine calcium measurement, serum parathyroid hormone measurement, serum phosphorus, magnesium, sodium, potassium, chloride measurement, serum alkaline phosphatase measurement, renal function test, ultrasound, electrocardiogram, X-ray film, electroencephalogram and so on.
Diagnosis
Diagnosis can be made on the basis of history and clinical manifestations, combined with the results of blood calcium test, urine calcium measurement, serum parathyroid hormone measurement, serum phosphorus, magnesium, sodium, potassium, chloride measurement, serum alkaline phosphatase measurement, renal function, color ultrasound, electrocardiogram, and other tests.
Treatment principle
Early detection, early treatment. Calcitonin, fluid replacement and diuresis, correction of electrolyte disorders, surgery and other treatment modalities are used to alleviate hypercalcemic crisis. Long-term treatment should correct the etiology.
Curability
As long as large amounts of fluid diuretics and calcitonin are given before renal failure, the symptoms can be relieved and conditions can be created for surgical removal of abnormal tissues. Successful surgery can normalize blood calcium in 3-4 days.
Dietary advice
Fasting or indwelling gastric tube is required for anorexia, nausea and vomiting.
Etiology
Etiology
The disease is caused by hyperparathyroidism.
Symptoms and Diagnosis
Typical symptoms
Polyuria and nocturia followed by poor appetite, nausea, vomiting, dehydration, azotemia, weakness, lethargy, high fever, rigors, convulsions and coma.
Diagnostic basis
1. presence of hyperparathyroidism. 2. serum ionized calcium more than 1.87 mmol/L. If the blood calcium > 3.75 mmol/L, even if asymptomatic or not obvious, should be treated as hypercalcemic crisis. 3. clinical symptoms of crisis.
Treatment
Treatment guidelines
Hypercalcemic crisis should be treated with calcitonin, fluid replacement diuretic therapy, correction of electrolyte disorders, surgery, etc. to alleviate the symptoms of hypercalcemia, and the cause of the disease should be corrected in the long-term treatment.
Drug treatment
Infusion of large amounts of saline, correction of electrolyte disorders, use of diuretics, phosphates, phosgene, calcitonin, glucocorticoids and other drugs.
Surgery
Early surgical removal of abnormal tissues, such as parathyroid adenoma, for primary hyperparathyroidism.
Other treatments
Hypercalcemic crisis can be treated with dialysis, which can rapidly reduce blood calcium.
Prognosis
Aggressive resuscitation and surgical removal of abnormal tissues can reduce symptoms and prolong survival. k
Nursing care
Daily care
1. Actively treat the primary disease, pay attention to the combination of work and rest. 2. Adhere to the medication as prescribed by the doctor, and review regularly. 3.
Dietary adjustments
Normal diet.