Total parenteral nutrition (TPN) is a proven adjunct to the management of severely debilitated patients in whom oral or tube feeding is ineffective or contraindicated.1-4 Several studies have shown that the use of TPN in inflammatory bowel disease has led to better nutritional preparation for surgery, amelioration of symptoms and radiographic findings, and possibly even remission.5-7 Reported complications of the use of TPN include hypophosphatemia, acidosis, hyperglycemia, and hyperosmolar coma.1-4 The present report concerns a child with severe Crohn's disease who developed marked hypercalciuria associated with renal calculi while receiving TPN. After removal of calcium from the TPN solution, there was rapid disappearance of hypercalciuria followed by passage and dissolution of calculi.
Parathyroid carcinoma presenting as hyperosmolar coma
