Secondary hyperparathyroidism manifesting as acute pancreatitis and status epilepticus
| Autor: | Marvin Goldberg, Alan Sallman, Duane G. Wombolt |
|---|---|
| Rok vydání: | 1981 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Status epilepticus Gastroenterology Subtotal Parathyroidectomy Parathyroid Glands Status Epilepticus Internal medicine Internal Medicine medicine Humans Hyperparathyroidism medicine.diagnostic_test business.industry Lumbar puncture medicine.disease Surgery Pancreatitis Acute Disease Acute pancreatitis Secondary hyperparathyroidism Hyperparathyroidism Secondary Hemodialysis medicine.symptom business |
| Zdroj: | Archives of internal medicine. 141(11) |
| ISSN: | 0003-9926 |
| Popis: | A 36-year-old with end-stage renal disease secondary to hypertensive nephrosclerosis had a two-day history of epigastric pain and nausea. Soon after admission, multiple grand mal seizures uncontrolled by intravenous phenytoin sodium and diazepam developed. His calcium level was 14 mg/dL and his amylase level was 2,230 mg/dL; lumbar puncture was normal. Hemodialysis lowered his calcium level to 10.7 mg/dL but failed to control his seizures. Secondary hyperparathyroidism was thought to be the cause of his malignant hypercalcemia, and an emergency subtotal parathyroidectomy was performed. Postoperatively, his grand mal seizures resolved. Confusion and aphasia also developed, but they resolved over the ensuing three weeks. Microscopic examination of the parathyroid glands revealed diffuse chief cell hyperplasia. Preoperative parathormone level was 2,196 pg/dL (normal, less than 450 pg/dL). A review of the literature has failed to reveal a similar case. |
| Databáze: | OpenAIRE |
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