Treatment of extreme hypercalcaemia: the role of haemodialysis.
| Autor: | Basok AB; Department of Nephrology, Soroka University Medical Center, Beer Sheva, Israel., Rogachev B; Department of Nephrology, Soroka University Medical Center, Beer Sheva, Israel., Haviv YS; Department of Nephrology, Soroka University Medical Center, Beer Sheva, Israel., Vorobiov M; Department of Nephrology, Soroka University Medical Center, Beer Sheva, Israel. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2018 Jun 04; Vol. 2018. Date of Electronic Publication: 2018 Jun 04. |
| DOI: | 10.1136/bcr-2017-223772 |
| Abstrakt: | A patient with extremely high calcium level of 23.9 mg/dL (5.97 mmol/L) was admitted to our department unconscious with pathological ECG recording, demonstrating shortening of QT interval. The patient was treated by fluid resuscitation, bisphosphonates, salmon calcitonin and steroids. Haemodialysis with low calcium bath had been promptly provided with improvement of consciousness and calcium level. ECG changes disappeared. Subsequent investigations revealed hyperparathyroidism and a large parathyroid adenoma was then surgically removed. Extreme and rapid calcium elevation (parathyroid crisis) is rarely seen in primary hyperparathyroidism and usually is distinctive for malignancy. In the context of acute kidney injury and refractory hypercalcaemia with life-threatening complications (coma, ECG changes with impending danger of arrhythmia), haemodialysis may effectively decrease calcium levels. It should be pointed out that dialysis is an efficient method of treatment of refractory hypercalcaemia, parathyroid crisis, but it is rarely used due to its invasive nature. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|