Skip to main content

Hyperparathyroidism, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Parathyroid hormone (PTH) excess with symptoms owing to PTH actions:

    • Decreases urinary Ca2+ loss

    • Increases urinary PO42− loss

    • Stimulates vitamin D conversion from 25(OH)-D to 1,25(OH)-D...

Diagnosis

Signs and Symptoms

Stones, bones, abdominal groans, and psychiatric moans 
  • Hypercalcemic crisis:

    • Anorexia, nausea, vomiting

    • Mental obtundation

History

Depends on the severity and rapidity of hyper...

Treatment

Pre-Hospital

May present as a primarily psychiatric disorder 

Initial Stabilization/Therapy

  • Cardiac monitor if:

    • Symptomatic hypercalcemia

    • Ca2+ level >14 mg/dL

  • Hydrate with IV 0.9% NS.

  • Correct ac...

Follow-Up

Disposition

Admission Criteria

  • Corrected calcium >14 mg/dL

  • Symptomatic hypercalcemia

  • Evidence of abnormal cardiac rhythm or conduction

Discharge Criteria

  • Not meeting admission criteria

  • Able to m...

Pearls and Pitfalls

  • The hypercalcemia of hyperparathyroidism is rarely symptomatic and Ca2+ level rarely >14. (Higher levels are most frequently attributable to neoplastic disease)

  • The importance of...

Additional Reading

  • Andreoli  TE, Carpenter  CCJ, Cecil RL. Andreoli and Carpenter's Cecil Essentials ofMedicine. 7th ed. Philadelphia, PA: Saunders-Elsevier; 2007.

  • Goldman  L, Bennett  JC, eds. Cecil'...

Codes

ICD9

  • 252.00 Hyperparathyroidism, unspecified

  • 252.01 Primary hyperparathyroidism

  • 252.02 Secondary hyperparathyroidism, non-renal

  • 252.08 Other hyperparathyroidism

  • 252.0 Hyperparathyroidism

ICD10

  • E21.0 Pr...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×