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Related Experiment Video

Updated: Sep 21, 2025

Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
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Masked Primary Hyperparathyroidism by Empagliflozin Use.

Mariam Awada1, Zeinab Melhem1, Zeinab M Khalaf2

  • 1Endocrinology and Diabetes, Faculty of Medical Sciences, Lebanese University, Beirut, LBN.

Cureus
|June 2, 2022
PubMed
Summary
This summary is machine-generated.

Sodium-glucose cotransporter-2 inhibitors like empagliflozin can mask primary hyperparathyroidism. This case highlights the importance of considering this rare drug interaction in diabetic patients with hypercalcemia.

Keywords:
antidiabetic drugsempagliflozinhypercalcemiahyperparathyroidismmasked primary hyperparathyroidism

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Last Updated: Sep 21, 2025

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Area of Science:

  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are widely used for type 2 diabetes management.
  • Empagliflozin, an SGLT2i, reduces renal glucose reabsorption, potentially affecting calcium homeostasis.
  • Primary hyperparathyroidism is a condition of excess parathyroid hormone leading to hypercalcemia.

Observation:

  • A 57-year-old male diabetic patient on empagliflozin for two years presented with hypercalcemia.
  • Initial parathyroid hormone levels were equivocal, complicating the diagnosis.
  • Discontinuation of empagliflozin revealed persistent hypercalcemia and elevated parathyroid hormone.

Findings:

  • The patient was diagnosed with primary hyperparathyroidism.
  • Empagliflozin use was implicated in masking the typical presentation of primary hyperparathyroidism.
  • This represents a rare but significant drug-induced diagnostic challenge.

Implications:

  • Clinicians should consider SGLT2 inhibitors as a potential masking agent for primary hyperparathyroidism in diabetic patients.
  • Careful evaluation of calcium and parathyroid hormone levels upon medication review is crucial.
  • Further research into the mechanisms of SGLT2 inhibitors on calcium metabolism is warranted.