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December 9, 1974

Hypercalcemic and Hypocalcemic Crises

Author Affiliations

From the Endocrine-Metabolic Unit and the Department of Medicine, Peter Bent Brigham Hospital, and Harvard Medical School, Boston. Dr. Himathongkam is a fellow of the Population Council.

JAMA. 1974;230(10):1438-1439. doi:10.1001/jama.1974.03240100056034

THE crisis of acute hypercalcemia constitutes one of the more common endocrine emergencies. Within the past few years, new therapeutic modalities have become available for the medical management of this entity. We review these modalities and suggest a regimen for the rational treatment of the hypercalcemic patient. In addition, a system of medical management will be presented for the treatment of the patient with acute hypocalcemia.

Hypercalcemic Crisis 

Diagnosis.—  Acute hypercalcemia can have a variety of manifestations.1 Common symptoms include nausea and vomiting (with subsequent dehydration), anorexia, constipation, and polyuria. Severe abdominal pain is common and frequently is related to an associated peptic ulcer or pancreatitis. Other symptoms include weakness ranging from mild fatigue to neuromuscular paralysis, fever, and coma.Objective signs include ectopic calcification, such as band keratopathy, nephrocalcinosis, arterial calcification, and skin calcification. A decreased Q-T interval is seen on the electrocardiogram.The most common causes of

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