Management of severe hypercalcaemia secondary to primary hyperparathyroidism: The efficacy of saline hydration, furosemide, and zoledronic acid

• Published in: Endocrinology, diabetes & metabolism diabetes & metabolism, 2022-11, Vol.5 (6), p.e380-n/a
• Main Authors: Oueslati, Ibtissem, Kardi, Asma, Yazidi, Meriem, Abidi, Sahar, Chaker, Fatma, Mellassi, Seifeddine, Chihaoui, Melika
• Format: Article
• Language: English
• Subjects: Acids; Adult; Aged; Anorexia; Bisphosphonates; Calcium - therapeutic use; Cardiac arrhythmia; Creatinine; Electrocardiography; emergency; furosemide; Furosemide - therapeutic use; Hemodialysis; Humans; Hydration; Hypercalcemia; Hypercalcemia - drug therapy; Hypercalcemia - etiology; Hyperparathyroidism, Primary - complications; Hyperparathyroidism, Primary - drug therapy; Middle Aged; Patients; primary hyperparathyroidism; Retrospective Studies; saline hydration; Saline Solution - therapeutic use; severe hypercalcaemia; Ultrasonic imaging; Vitamin deficiency; Zoledronic Acid - therapeutic use
• ISSN: 2398-9238; 2398-9238
• DOI: 10.1002/edm2.380

Introduction Severe hypercalcaemia is a life‐threatening condition that should be managed urgently. The aim of this study was to assess the efficacy of saline hydration, furosemide, and zoledronic acid in the management of severe hypercalcaemia secondary to primary hyperparathyroidism (PHPT). Methods We conducted a retrospective analysis of the management of 65 patients with severe hypercalcaemia (≥3 mmol/L) secondary to PHPT. The efficacy of each therapeutic agent was evaluated according to the variation in serum calcium level calculated as Δ calcium = initial calcium level – minimal calcium level reached after the administration of each agent. Results The mean age of patients was 56.4 ± 13.8 years. At baseline, the mean total serum calcium level was 3.42 ± 0.40 mmol/L. After normal saline hydration, calcium level decreased from 3.25 ± 0.21 to 2.98 ± 0.2 mmol/L (p