{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:59:54Z","timestamp":1778155194979,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2010,11,2]],"date-time":"2010-11-02T00:00:00Z","timestamp":1288656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The clinical and pathological characteristics of hyperparathyroidism\u2010induced hypercalcemic crisis (HIHC) are incompletely described. The present study was designed to elucidate the nature and effects of HIHC in patients undergoing parathyroidectomy in our unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective database of 1,754 consecutive patients with primary hyperparathyroidism (PHPT) who underwent parathyroidectomy from 1991\u20132009 identified 67 (41 women) patients presenting with HIHC. Hyperparathyroidism\u2010induced hypercalcemic crisis was defined as symptoms and signs of acute calcium intoxication with a concomitant total albumin corrected calcium level &gt;13.5\u00a0mg\/dl (range: 8.8\u201310.2\u00a0mg\/dl). Clinical and pathological characteristics were evaluated. Data are expressed as mean \u00b1 SEM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age at presentation was 56.7 \u00b1 2.2 years. Twenty\u2010four of 67 patients (35%) required preoperative in\u2010hospital management. Of these, all were treated with saline resuscitation, whereas 20\/24 (83%) were treated pharmacologically. Neurocognitive derangements and nephrolithiasis with associated hematuria were the most common presenting symptoms and signs. Preoperative serum calcium and the intact parathyroid hormone level (PTH) were 14.0 \u00b1 0.19\u00a0mg\/dl and 393 \u00b1 43 pg\/ml (reference range: 12\u201365 pg\/ml), respectively. Minimally invasive parathyroidectomy under local cervical block was performed in 28\/67 patients (42%); the remainder underwent standard cervical exploration. All patients had postoperative normalization of serum calcium and intact PTH. Hyperparathyroidism\u2010induced hypercalcemic crisis was due to parathyroid carcinoma in 3\/67 patients (4.5%), whereas the remainder of patients displayed a single parathyroid adenoma (<jats:italic>n<\/jats:italic> = 57) or multiglandular hyperplasia (<jats:italic>n<\/jats:italic> = 7). Histopathological evaluation from HIHC patients revealed a chief cell microcystic pattern in 15\/21 (71.4%) of examined parathyroid tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hyperparathyroidism\u2010induced hypercalcemic crisis is most commonly due to a single parathyroid adenoma, often associated with a microcystic histopathological pattern. The condition is optimally managed with saline hydration and urgent parathyroidectomy.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-010-0840-6","type":"journal-article","created":{"date-parts":[[2010,11,2]],"date-time":"2010-11-02T15:30:22Z","timestamp":1288711822000},"page":"331-335","source":"Crossref","is-referenced-by-count":35,"title":["Clinical and Histopathological Characteristics of Hyperparathyroidism\u2010induced Hypercalcemic Crisis"],"prefix":"10.1002","volume":"35","author":[{"given":"Lee F.","family":"Starker","sequence":"first","affiliation":[{"name":"Department of Surgery Yale University School of Medicine P.O. Box 208062 06520\u20108062 New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peyman","family":"Bj\u00f6rklund","sequence":"additional","affiliation":[{"name":"Department of Surgery Yale University School of Medicine P.O. Box 208062 06520\u20108062 New Haven CT USA"},{"name":"Department of Surgical Sciences Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantine","family":"Theoharis","sequence":"additional","affiliation":[{"name":"Department of Pathology Yale University School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"William D.","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Surgery Yale University School of Medicine P.O. Box 208062 06520\u20108062 New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Carling","sequence":"additional","affiliation":[{"name":"Department of Surgery Yale University School of Medicine P.O. Box 208062 06520\u20108062 New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Udelsman","sequence":"additional","affiliation":[{"name":"Department of Surgery Yale University School of Medicine P.O. Box 208062 06520\u20108062 New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,11,2]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.141.7.696"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010197705000\u201000003"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V12suppl_1s3"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1932.27410660002010a"},{"key":"e_1_2_5_6_2","first-page":"734","article-title":"Primary hyperparathyroidism causing hypercalcemic crisis and acute pancreatitis","volume":"49","author":"Flink EB","year":"1966","journal-title":"Minn Med"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0929\u20106646(09)60346\u20106"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-60-3-447"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010196712000\u201000021"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.141.4.401"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010008\u20109567\u2010z"},{"key":"e_1_2_5_12_2","first-page":"105","article-title":"Minimally invasive parathyroid surgery","volume":"57","author":"Roman S","year":"2002","journal-title":"Minerva Chir"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010197912000\u201000019"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109610(81)90420\u20107"},{"key":"e_1_2_5_15_2","first-page":"141","article-title":"Treatment of hypercalcemia associated with malignancy","volume":"5","author":"Mazzaferri EL","year":"1978","journal-title":"Semin Oncol"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.2.485"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4615-6355-6_9"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP.11.6.389"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-010-0840-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-010-0840-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-010-0840-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-010-0840-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T23:30:36Z","timestamp":1703633436000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-010-0840-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,11,2]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,2]]}},"alternative-id":["10.1007\/s00268-010-0840-6"],"URL":"https:\/\/doi.org\/10.1007\/s00268-010-0840-6","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11,2]]}}}