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An unrecognized cause of recurrent hypercalcemia: immobilization
Chih-Jen Cheng1, Chung-Hsing Chou, Shih-Hua Lin
1Division of Nephrology, Department of Medicine, and the Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Southern Medical Journal
|April 26, 2006
Summary
Immobilization can cause hypercalcemia (high blood calcium) and worsen kidney failure, even after stroke. Early recognition and rehabilitation exercises with bisphosphonates effectively treated this rare condition.
Area of Science:
- Nephrology
- Neurology
- Endocrinology
Background:
- A 66-year-old man with chronic renal insufficiency and gout presented with stroke symptoms.
- The patient developed conscious disturbance, hypercalcemia, and acute kidney injury.
Observation:
- Initial workup for hypercalcemia was inconclusive, suggesting a nonparathyroidal origin.
- Standard treatments for hypercalcemia and renal failure provided only temporary relief.
Findings:
- Immobilization hypercalcemia was diagnosed after excluding other causes.
- Treatment with rehabilitative exercises and bisphosphonates led to sustained recovery.
Implications:
- Recognizing immobilization hypercalcemia is crucial for timely diagnosis and treatment.
- This diagnosis can prevent unnecessary invasive procedures and complications.
- Prompt management can avoid recurrence of hypercalcemia and renal failure.
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