Depending upon the method of measurement, hypocalcemia occurs in 15% to 88% and hypercalcemia occurs in 15% of hospitalized patients. Ionized calcium should be measured in place of total serum calcium to avoid errors related to hypoalbuminemia, which is seen commonly in acutely ill patients. Symptomatic hypocalcemia requires prompt intravenous…
Vitamin D deficiency occurs more frequently in patients with primary hyperparathyroidism (PHPT) compared with the general population, and is usually associated with an aggravated form of the disease. Current guidelines recommend measurement of serum levels of 25-hydroxy vitamin D (25-OHD) in all patients with PHPT, and their repletion if the…
Penile cancer is very rare in North America and Europe, as compared with the rest of the world. Squamous cell carcinoma (SCC) accounts for more than 95% of the cancer type. Paraneoplastic syndrome (PNS), a clinical syndrome of nonmetastatic systemic effects that occurs in patients with malignant disease, is often…
Primary hyperparathyroidism is commonly due to a single, sporadic parathyroid adenoma, and surgery is considered the treatment of choice based on guidelines established by the National Institutes of Health consensus panel. While there is no established medical therapy for this condition, pharmacotherapy with agents such as cinacalcet could be a…
Abstract:A 52-year-old woman was admitted with complaints of nonhealing skin ulcers. The laboratory assessment showed a calcium level of 13.2 mg/dL (normal 8.4–10.2 mg/dL), albumin 2 g/dL (normal 3.5–4.8 g/dL), corrected calcium 14.8 mg/dL, phosphorus 1.4 mg/dL (normal 2.4–4.7 mg/dL), creatinine 0.7 mg/dL (normal 0.5–1.2 mg/dL), parathyroid hormone 893.3 pg/mL…
A 65-year-old Caucasian woman with a known history of clear cell endometrial cancer presented with hypercalcemia. Further evaluation demonstrated that the patient had primary hyperparathyroidism due to a parathyroid adenoma, as well as an increased parathyroid hormone-related peptide secondary to her malignancy. To the best of our knowledge, this is…
A 53-year-old man with no past medical history was admitted with complaints of hematuria, flank and abdominal pain of one week duration. He also complained of an enlarging new neck mass one month before presentation. The laboratory assessment showed a calcium level of 17.3 mg/dL (normal 8.5–10.5 mg/dL), serum albumin…
Abstract:We report a 66-year-old Chinese man with chronic renal insufficiency (creatinine 1.7 mg/dL) and gout suffering from slurred speech and right hemiplegia for 3 days. Acute cerebral infarction was confirmed by computed tomography. Conscious disturbance occurred on the tenth hospital day without significant changes on imaging study when compared with…
Sarcoidosis is a granulomatous, multisystem disease. Rarely, sarcoidosis may present with both renal failure and hypercalcemia. A 27-year-old black man presented with severe abdominal pain and renal failure. A kidney biopsy demonstrated features of both interstitial nephritis and membranous glomerulopathy thought to be secondary to nonsteroidal anti-inflammatory drugs. His renal…
We describe a case of pronounced symptomatic hypercalcemia as a consequence of thyrotoxicosis alone. Primary hyperparathyroidism and other secondary causes of hypercalcemia were excluded. Hypercalcemia completely abated after treatment of thyrotoxicosis. Notwithstanding that hypercalcemia is an unusual manifestation of hyperthyroidism, asymptomatic elevation of serum calcium concentration had been documented in…
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