In the context of acute kidney injury and refractory hypercalcaemia with life-threatening complications (coma, ECG changes with impending danger of arrhythmia), haemodialysis may effectively decrease calcium levels.
Extreme and rapid calcium elevation (parathyroid crisis) is rarely seen in primary hyperparathyroidism and usually is distinctive for malignancy. Subsequent investigations revealed hyperparathyroidism and a large parathyroid adenoma was then surgically removed. Haemodialysis with low calcium bath had been promptly provided with improvement of consciousness and calcium level. The patient was treated by fluid resuscitation, bisphosphonates, salmon calcitonin and steroids. A patient with extremely high calcium level of 23.9 mg/dL (5.97 mmol/L) was admitted to our department unconscious with pathological ECG recording, demonstrating shortening of QT interval.
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