Catastrophic femoral vein thrombosis in a patient with hypercalcemia due to parathyroid adenoma: a case report

Hypercalcemia is usually a consequence of malignant tumor, hyperparathyroidism, end-stage renal disease, and the use of diuretics. Hypercalcemic crisis has been defined as elevated serum level of ionized calcium, but it has never been related to the formation of catastrophic thrombosis. Here we reported a case of catastrophic femoral vein thrombosis, leading to muscular necrosis in the leg. The thrombus formed at the site of catheterization. The necrosis progressed despite intensive anticoagulation strategies. Eventually, the patient died of multiple organ failure due to severe sepsis. Clinical implications of the case included: (I) if a patient has hypercalcemia, cautions should be practiced in performing deep vein catheterization. Alternatively, anticoagulation may be considered to prevent femoral vein thrombosis; (II) hypercalcemia maybe a relative contraindication for femoral vein thrombosis, which has never been proposed in the literature.