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Acute Respiratory Distress Syndrome Induced by Parathyroid Storm

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Journal Cureus
Date 2021 Feb 26
PMID 33633910
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Abstract

Hypercalcemic crisis associated with the development of acute respiratory distress syndrome (ARDS) has been rarely documented in the literature. Most cases have been described in patients suffering from malignancies or renal failure with the presence of metastatic calcifications being a prominent feature. Only three cases of ARDS have been reported to date in patients with hypercalcemic crisis due to primary hyperparathyroidism (PHPT). Herein, we report a 72-year-old patient with PHPT that presented with severe hypercalcemic crisis and developed ARDS. He had mild chronic kidney disease and at presentation he had extremely high levels of serum calcium (22.5 mg/dl) and parathormone (3822 pg/ml). After receiving medical treatment for hypercalcemia and the initiation of hemodialysis, he developed ARDS with a fatal outcome, without the presence of pancreatitis, sepsis or heart failure. Although very rare, ARDS should be taken into account as a possible complication of parathyroid crisis, especially in patients with excessive calcium and parathormone levels.

References
1.
Wymenga A, van der Werf T, van der Graaf W, Tulleken J, Zijlstra J, Ligtenberg J . Lessons from an unusual case: malignancy associated hypercalcemia, pancreatitis and respiratory failure due to ARDS. Neth J Med. 1999; 54(1):27-30. DOI: 10.1016/s0300-2977(98)00077-1. View

2.
Chen H, Yeh D, Kao S . The detrimental role of inducible nitric oxide synthase in the pulmonary edema caused by hypercalcemia in conscious rats and isolated lungs. J Biomed Sci. 2007; 15(2):227-38. DOI: 10.1007/s11373-007-9211-1. View

3.
Ahmad S, Kuraganti G, Steenkamp D . Hypercalcemic crisis: a clinical review. Am J Med. 2014; 128(3):239-45. DOI: 10.1016/j.amjmed.2014.09.030. View

4.
Singh D, Gupta S, Kumari N, Krishnani N, Chand G, Mishra A . Primary hyperparathyroidism presenting as hypercalcemic crisis: Twenty-year experience. Indian J Endocrinol Metab. 2015; 19(1):100-5. PMC: 4287752. DOI: 10.4103/2230-8210.131763. View

5.
Valdivielso P, Lopez-Sanchez J, Garrido A, Sanchez-Carrillo J . Metastatic calcifications and severe hypercalcemia in a patient with parathyroid carcinoma. J Endocrinol Invest. 2006; 29(7):641-4. DOI: 10.1007/BF03344164. View