The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Case Report

An Unusual Cause of Hypercalcemia

Authors: Kai Ming Chow, MD, Cheuk Chun Szeto, MD

Abstract

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 up to one-fourth of patients with proved hyperthyroidism. The current case is unusual in that the patient demonstrated a significant degree of hypercalcemia secondary to hyperthyroidism alone, with a serum calcium level as high as 3.14 mmol/L. We further discuss the putative pathophysiology of this “thyroid bone disease,” highlighting the repercussion on calcium and bone metabolism in hyperthyroidism.

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