REHYDRATION AS A DIAGNOSTIC AND THERAPEUTIC MEASURE IN HYPERCALCEMIA

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Abstract
Two patients in a hypercalcemic crisis received fluid replacement therapy, which sufficed to control their condition. Both of them developed a marked polyuria even before they were clinically rehydrated and large amounts of calcium were demonstrated in the urine. A third patient, who clinically presented with the most pronounced symptoms of hypercalcemia, did not produce polyuria or hypercalciuria when rehydrated. It is suggested that the presence or absence of polyuria upon rehydration may serve to distinguish between hypercalcemic crisis sensu strictu and hypercalcemia with less rapid calcium mobilization. When the two first mentioned patients had been brought into a steady state with a stable, but elevated serum calcium and a constant, but abnormally high daily excretion of calcium in the urine, porcine calcitonin was administered. One patient responded with a drop in serum calcium and phosphaturia, both parameters reverting to pretreatment values upon cessation of the drug. In the other patient serum calcium was abruptly normalized, urinary excretion diminished and the effect was sustained.