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Lethal hyperparathyroid crisis: hazards of phosphate administration

Vernava, A.M.; O'Neal, L.W.; Palermo, V.

Surgery 102(6): 941-948

1987

ISSN/ISBN: 0039-6060
PMID: 3686357
Document Number: 300361
Two patients with hypercalcemia crisis and parathyroid adenoma died as a result of pulmonary insufficiency. The administration of phosphate is believed to have contributed to the deaths, since the pulmonary problems appeared when the blood [Ca] X [PO4] product rose and extensive metastatic calcification was present in the pulmonary alveolar lining. The use of phosphates as calcium-lowering agents in hypercalcemia is discouraged, because phosphate appears to lower calcium levels only by intravascular precipitation.

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