Endocrine Abstracts

Introduction: Severe hypercalcemia is an uncommon but potentially life-threatening condition. Calcium plays a variety of roles and explains the impact of hypercalcemia on the functioning of different organs. We report the case of a patient with severe hypercalcemia revealed by a confusional syndrome.

Observation: A 60 year old male patient, with a medical history of hypertension under treatment, presented a confusional syndrome of progressive onset which worsened towards agitation and disturbance of consciousness hence his admission to the emergency room. The biological assessment was in favor of hypercalcemia at 210 mg/l, a functional renal insufficiency and hyperparathonemia at 2217 pg /ml (33 × the normal range). The patient benefited from rehydration associated with 2 sessions of dialysis due to agitation and worsening of his symptomatology, as well as specific treatments, inhibiting bone resorption. Unfortunately the evolution was marked by the death of the patient.

Discussion and Conclusion: Hypercalcemia is a life-threatening emergency with potentially fatal cardiac, neurological and renal complications. The treatment of acute hypercalcemia will be undertaken in the intensive care unit and includes general measures such as rehydration and diuresis training by diuretics as well as specific treatments, inhibiting bone resorption, biphosphonates associated initially or not with calcitonin.