[Abstract] [Full Text PDF] (in Japanese / 414KB) [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 94(10): 1125-1130, 1993


Original article

ANALYSIS OF 30 PATIENTS WITH HYPERCALCEMIA

Department of Surgery II, Osaka University Medicine School, Osaka, Japan

Tetsuro Kobayashi, Masashi Baba, Norifumi Tanaka, Tsutomu Takeda, Eiichi Shiba, Shin-ichiro Takai, Takesada Mori

We have treated 30 patients with hypercalcemia from 1984 to 1991. Twenty four out of 30 patients were associated with primary hyperparathyroidism and the other six were associated with malignancy. Of 24 cases primary hyperparathyroidism, 15 were due to single parathyroid adenoma, five to MEN 1 and one to familial hyperparathyroidism. In the other three cases, it was difficult to identify the cause of the hyperparathyroidism.
Following conclusions were obtained:
1. Hypercalcemia shows no specific and characteristic symptoms, so it is essential to keep hypercalcemia in mind in diagnosis of patients with vague or general complaints.
Malignancy associated hypercalcemia shows high serum calcium level and PTH level. When considering malignancy, it is easy to diagnose that it might be the cause of hypercalcemia.
2. When serum PTH is over 2000pg/ml (high sensitivity PTH assay) in primary hyperparathyroidism, the probability of swelling of multiple parathyroid glands should be considered in evaluation of localization study and surgery. When serum PTH is high or swelling of multiple glands is found. It is essential to evaluate the possibility of MEN 1.


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