Author(s): Francesca Pellicciotti | Andrea Giusti | Maria Carolina Gelli | Salvatore Foderaro | Alberto Ferrari | Giulio Pioli
Journal: World Journal of Clinical Oncology
ISSN 2218-4333
Volume: 3;
Issue: 1;
Start page: 7;
Date: 2012;
Original page
Keywords: Bisphosphonates | Hypercalcemia | Malignancy-associated hypercalcemia | Parathyroid hormone | Primary hyperparathyroidism
ABSTRACT
The hypercalcemias are a common and heterogeneous group of disorders, ranging from the occasional detection of a high level of serum calcium to a life-treating condition. In a patient presenting with hypercalcemia, a differential diagnosis can be established easily by measuring serum calcium and parathyroid hormone (PTH) concentrations. We describe the case of an 83-year-old man presenting with a severe symptomatic hypercalcemia with high-normal PTH level due to the coexistence of primary hyperparathyroidism and malignancy-associated hypercalcemia. The presence of two conditions producing hypercalcemia was revealed only during in-hospital stay and after the administration of an intravenous bisphosphonate, when the PTH concentration increased rapidly after bisphosphonate treatment with a decrease in serum calcium. The occurrence of two conditions producing hypercalcemia is a rare event in the literature, and should be considered in the presence of an abnormally high serum calcium level associated with normal or high-normal PTH, in order to establish a correct diagnosis and appropriate interventions.
Journal: World Journal of Clinical Oncology
ISSN 2218-4333
Volume: 3;
Issue: 1;
Start page: 7;
Date: 2012;
Original page
Keywords: Bisphosphonates | Hypercalcemia | Malignancy-associated hypercalcemia | Parathyroid hormone | Primary hyperparathyroidism
ABSTRACT
The hypercalcemias are a common and heterogeneous group of disorders, ranging from the occasional detection of a high level of serum calcium to a life-treating condition. In a patient presenting with hypercalcemia, a differential diagnosis can be established easily by measuring serum calcium and parathyroid hormone (PTH) concentrations. We describe the case of an 83-year-old man presenting with a severe symptomatic hypercalcemia with high-normal PTH level due to the coexistence of primary hyperparathyroidism and malignancy-associated hypercalcemia. The presence of two conditions producing hypercalcemia was revealed only during in-hospital stay and after the administration of an intravenous bisphosphonate, when the PTH concentration increased rapidly after bisphosphonate treatment with a decrease in serum calcium. The occurrence of two conditions producing hypercalcemia is a rare event in the literature, and should be considered in the presence of an abnormally high serum calcium level associated with normal or high-normal PTH, in order to establish a correct diagnosis and appropriate interventions.
