Hyperthyroidism-associated hypercalcemic crisis: A case report and review of the literature.

Ke Chen, Yanhong Xie, Liling Zhao, Zhaohui Mo

Journal: Medicine 2017;96(4):e6017

PMID: 28121960

Abstract

RATIONALE

Hyperthyroidism is one of the major clinical causes of hypercalcaemia, however, hyperthyroidism-related hypercalcemic crisis is rare, only 1 case have been reported. The potential mechanisms are still not too clear. It may be related that thyroid hormone stimulate bone turnover, elevate serum calcium, increase urinary and fecal calcium excretion.

PATIENT CONCERNS

A 58-year-old female patient was found to have Graves' disease, a marked elevated serum calcium level (adjusted serum calcium: 3.74 mmol/L), and reduced parathyroid hormone level.

DIAGNOSES

She was diagnosed as hyperthyroidism-associated hypercalcemic crisis.

INTERVENTIONS

Treatment with methimazole to correct the hyperthyroidism and treatment of the patient's hypercalcaemia was achieved by physiological saline, salmon calcitonin and furosemide.

OUTCOMES

After treatment for hypercalcaemia and hyperthyroidism, her symptoms and serum calcium levels quickly returned to normal.

LESSONS

hyperthyroid-associated hypercalcaemia crisis is rare, however, the diagnosis should pay attention to screening for other diseases caused by hypercalcemia. Timely treatment of hypercalcaemia is a critical step for rapidly control of symptoms, and treatment of hyperthyroidism is beneficial to relief the symptoms and maintain the blood calcium level.

Address: Department of Endocrinology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
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