A rare case of parathyroid crisis with respiratory failure successfully treated using extracorporeal membrane oxygenation

Ikegaki, Shunkichi; Otoshi, Takehiro; Hirai, Tomoyuki; Hirabayashi, Masataka

doi:10.1016/j.rmcr.2020.101088

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…As illustrated in Figure 1 , we found only 10 cases where other causes of pulmonary edema were sufficiently excluded to allow for hypercalcemia-induced ARDS to be the most likely diagnosis. Of these, the only 2 patients to survive had acute parathyroidectomies, and were supported with renal replacement therapy and extra-corporeal membrane oxygenation (ECMO) therapy if needed [ 8 , 9 ]. As discussed earlier, given the mechanism by which the calcifications envelope the alveoli, ECMO as a feasible therapeutic option can be physiologically justified.…”

Section: Discussionmentioning

confidence: 99%

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Acute respiratory distress syndrome driven by severe hypercalcemia and acute kidney injury: A case report and literature review of a rare, life-threatening complication

Selvaskandan¹,

Hull²,

Gregory³

et al. 2022

CNCS

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Acute respiratory distress syndrome (ARDS) is a rare and under-reported complication of hypercalcemia, which often presents in conjunction with acute kidney injury (AKI). Unfamiliarity with the condition inevitably leads to management uncertainty, resulting in fatal outcomes. Early identification, however, confers a good prognosis. We report a case of a 40-year-old male who presented with severe hypercalcemia and AKI and rapidly deteriorated due to ARDS, with no evidence of cardiogenic pulmonary edema or fluid overload. Infection screens were negative. He died despite invasive ventilation and continuous venous-venous hemofiltration. His autopsy revealed extensive metastatic pulmonary calcifications and alveolar edema. We found only 10 other cases of hypercalcemia-induced ARDS in the literature, with only 2 patients surviving. We provide the first literature review on the subject to guide the management of this rare but fatal complication, which can be managed with good outcomes if considered early.

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Section: Discussionmentioning

confidence: 99%

“…Perhaps most crucially, if the underlying cause of the hypercalcemia can be treated, then both MPC and ARDS can rapidly resolve with correction of the calcium phosphate-product regardless of etiology with subsequent good outcomes [ 2 , 9 , 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Acute respiratory distress syndrome driven by severe hypercalcemia and acute kidney injury: A case report and literature review of a rare, life-threatening complication

Selvaskandan¹,

Hull²,

Gregory³

et al. 2022

CNCS

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“…A few cases of respiratory symptoms sustained by calcium deposition were reported in literature, often linked to pHPT due to parathyroid adenoma [ 7 , 8 , 9 ], none of which regarded pregnant women. In other reports, MPC was linked to another medical conditions, such as multiple myeloma [ 10 ] and chronic renal failure [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Only a few reports have described a metastatic pulmonary calcification (MPC) secondary to pHPT [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

A Fatal Case of Metastatic Pulmonary Calcification during the Puerperium

Chighine

Corona

Catani

et al. 2022

IJMS

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We present an unusual case of a fatal respiratory failure in a young woman developed two weeks after she gave birth at home. Circumstantial and clinical features of the case were strongly suggestive for a ‘classical’ septic origin of the respiratory symptoms. Autopsy, together with histopathological and immunohistochemical analyses allowed demonstrating a massive calcium redistribution consisting of an important osteolysis, especially from cranial bones and abnormal accumulation in lungs and other organs. Such physiopathology was driven by a primary hyperparathyroidism secondary to a parathyroid carcinoma as demonstrated by immunohistochemistry. This very rare case is furthermore characterised by a regular pregnancy course, ended with the birth of a healthy new-born. A complex interaction between pregnancy physiology and hyperparathyroidism might be hypothesised, determining the discrepancy between the relative long period of wellness and the tumultuous cascade occurred in the puerperium.

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Venoarterial-extra corporeal membrane oxygenation-assisted parathyroidectomy for hypercalcemic crisis due to parathyroid carcinoma complicated by severe circulatory and respiratory failure: a case report

et al. 2023

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Background Hypercalcemia crisis is a rare but severe form of hypercalcemia complicated by multiple organ failure. Hypercalcemia crisis due to hyperparathyroidism is commonly caused by a parathyroid tumor, which often requires surgical resection. However, there are no clear recommendations on when the surgery should be performed. Case presentation A 64-year-old female patient developed hyperparathyroidism due to a parathyroid tumor and hypercalcemic crisis, which was complicated by severe circulatory and respiratory failure refractory to medical therapy, and an emergent surgery was planned to resect the parathyroid tumor. To prevent intraoperative circulatory and respiratory collapse, venoarterial-extra corporeal membrane oxygenation (VA-ECMO) was introduced, resulting in a safe operation and anesthetic management. Conclusions In patients with hypercalcemic crisis complicated by severe circulatory and respiratory failure, induction of prophylactic VA-ECMO was useful for safe anesthetic management. Surgical resection should be performed as soon as the diagnosis is made before VA-ECMO is required.

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A rare case of parathyroid crisis with respiratory failure successfully treated using extracorporeal membrane oxygenation

Cited by 3 publications

References 10 publications

Acute respiratory distress syndrome driven by severe hypercalcemia and acute kidney injury: A case report and literature review of a rare, life-threatening complication

Acute respiratory distress syndrome driven by severe hypercalcemia and acute kidney injury: A case report and literature review of a rare, life-threatening complication

A Fatal Case of Metastatic Pulmonary Calcification during the Puerperium

Venoarterial-extra corporeal membrane oxygenation-assisted parathyroidectomy for hypercalcemic crisis due to parathyroid carcinoma complicated by severe circulatory and respiratory failure: a case report

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