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Intramuscular synthol injections cause hypercalcemia in long-term observation: a case report study
Magdalena Markowska1, Katarzyna Romejko2, Zuzanna Moszyńska2
1Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine-National Research Institute, 128 Szaserów Street, Warsaw, 04-141, Poland. mkowalczyk7@wim.mil.pl.
Background:
Hypercalcemia is one of the most common ionic disorders. It is diagnosed when the serum calcium concentration is greater than 10.5 mg/dL. While mainly associated with primary hyperparathyroidism and malignancy, it can also be caused by multiple derangements. Almost every part of the body can be affected by excess calcium. Hypercalcemia might be very dangerous and even lethal.
Case Presentation:
We report a rare trigger of increased serum calcium level - synthol intramuscular injections. A 60-year-old man who suffered from general weakness, weight loss and acute kidney injury, which were associated with unidentified hypercalcemia, was under review for proper diagnosis. We excluded endocrine disorders, malignancies, sarcoidosis, iatrogenic causes, which were defined as medication- related. Patient history, physical examination, blood chemistry, 24-hour urine collection, computed tomography and endoscopy were performed. Finally, the biopsy of muscle explained the source of the increased serum calcium concentrations.
Conclusions:
Hypercalcemia is a common disorder that has a wide range of triggers. Synthol intramuscular injections are among the causes of elevated serum calcium levels. It is important to make proper and quick diagnoses and begin therapy. Unfortunately, surgical resection of the synthol seems to be the only reasonable option for hypercalcemia treatment.
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