Abstract
Hypercalcemic crisis is a serious and potentially life-threatening complication of markedly increased serum calcium concentrations most commonly due to primary hyperparathyroidism. We report a case of an 80-year-old man with diabetes mellitus and chronic renal failure, who presented to the emergency department with somnolence, dysarthria and severe hypercalcemia (16.3mg/dL). Despite intensive treatment including elcatonin, alendronate, and intermittent hemodialysis with low calcium dialysate, serum calcium still reached high levels between hemodialysis treatments. The patient was then treated with 4mg of intravenous zoledronate. This treatment greatly reduced the serum calcium level and improved clinical symptoms without major adverse effects. The patient was diagnosed as having primary hyperparathyroidism and was treated by parathyroidectomy. Administration of zoledronate seems to be an effective modality for hypercalcemic crisis in patients with end-stage renal disease.
