-
Views
-
Cite
Cite
Toshiro Sugimoto, Masayoshi Sakaguchi, Nobuhiro Ogawa, Naoko Deji, Takashi Uzu, Yoshihiko Nishio, Yutaka Eguchi, Atsunori Kashiwagi, Marked hypercalcaemia in sepsis-induced multiple organ failure, Nephrology Dialysis Transplantation, Volume 22, Issue 4, April 2007, Pages 1272–1273, https://doi.org/10.1093/ndt/gfl703
Close - Share Icon Share
Extract
Sir,
A 58-year-old man was referred to our intensive care unit, because of retropharyngeal abscess and Staphylococcus aureus bacteraemia. On admission, he showed tachyponea, wheezing and oliguria. Laboratory examination revealed hypoxia, cardiac failure, lung congestion, renal dysfunction and marked inflammatory signs ( Table 1 ). He was diagnosed as having multiple organ failure due to sepsis, was intubated on a ventilator, and started on treatment with inotropes and antibiotics. This intensive treatment improved his clinical condition and laboratory abnormalities; however, on day 10, he showed marked hypertension (200/100 mmHg) and a new rise of serum creatinine level. An intravenous infusion of a calcium antagonist was thus initiated. On day 16, renal function was improved, but marked hypercalcaemia was noticed ( Table 1 ). The patient was treated with a single dose of intravenous pamidronate at 45 mg. Laboratory findings included normocalciuria, a low level of intact-parathyroid hormone (iPTH) and 1,25-dihydroxyvitamin D, an undetected iPTH-related protein level and normal thyroid and adrenal gland function. Six days after the dose of pamidronate, the plasma ionized calcium levels were reduced to normal ranges (1.27 mmol/l), and hypertension was improved. On day 27, his clinical condition was markedly improved, and he was transferred to the general ward; after rehabilitation, the patient was discharged on day 60.
Comments