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A case of temporary severe disequilibrium hypercalcemia
1Second Department of Internal Medicine, Osaka City University Medical School, Japan.
Mineral and Electrolyte Metabolism
|January 1, 1994
Summary
This case study describes temporary hypercalcemia in a 69-year-old woman, likely caused by increased bone resorption and reduced kidney function. The condition resolved with treatment and did not recur, suggesting a calcium regulation imbalance.
Area of Science:
- Nephrology
- Endocrinology
- Bone Metabolism
Background:
- Severe hypercalcemia can present with acute symptoms and renal dysfunction.
- Understanding the underlying causes of hypercalcemia is crucial for effective management.
Observation:
- A 69-year-old female patient presented with severe hypercalcemia (14.9 mg/dl) and renal dysfunction (creatinine 2.9 mg/dl).
- Elevated urinary pyridinoline and deoxypyridinoline indicated increased bone resorption.
- Decreased parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D levels were noted.
Findings:
- Hypercalcemia was attributed to increased bone resorption and impaired renal calcium excretion.
- Treatment with saline infusion and furosemide normalized serum calcium and creatinine levels.
- The patient remained normocalcemic eight months post-treatment without recurrence.
Implications:
- This case highlights 'disequilibrium hypercalcemia' resulting from a temporary imbalance in calcium regulation.
- The absence of recurrence suggests the hypercalcemia was not due to an underlying organic disease.
- Effective management involves addressing both bone resorption and renal excretion factors.