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BMJ Case Rep. 2010; 2010: bcr1020092416.
Published online Oct 21, 2010. doi:  10.1136/bcr.10.2009.2416
PMCID: PMC3028080
Unusual presentation of more common disease/injury
Vanishing polyuria and respiratory failure
Fabio Ruggieri,1 Alessandro Chiesa,2 Kathleen Schorn,1 Klaus Strobel,3 Marco Maggiorini,2 and Christoph Schmid4
1Department of Internal Medicine, Division of General Internal Medicine, University of Zurich, Zurich, Switzerland
2Department of Internal Medicine, Division of Medical Intensive Care, University of Zurich, Zurich, Switzerland
3Department of Radiology, Division of Nuclear Medicine, University of Zurich, Zurich, Switzerland
4Department of Internal Medicine, Division of Endocrinology, University of Zurich, Zurich, Switzerland
Correspondence to Fabio Ruggieri, statale113/at/hotmail.com
Abstract
A 44-year-old man with headache, sweating, subfebrile temperature and profound fatigue was found to have hypercalcaemic crisis with renal failure. Despite standard therapy, calcium levels remained high, he became anuric and developed multi-organ failure with acute respiratory distress syndrome requiring high ventilatory support, norepinephrine, dobutamine and continuous veno-venous haemodiafiltration. Ectopic calcification was found in the lungs, in the thyroid, kidneys, heart and stomach. A large parathyroid adenoma was then removed. When last seen, 11 months after surgery, the patient no longer required oxygen, and total lung capacity had returned to normal.
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