A challenging case of hypercalcemia

The authors report a case of hypercalcemia in a 79-year-old woman that led to multiple hospitalizations. The case was challenging because the hypercalcemia was ultimately found to have 2 distinct causes. The patient initially presented with an elevated parathyroid hormone (PTH) level, consistent wit...

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Bibliographic Details
Published in:The Journal of the American Osteopathic Association 2013-06, Vol.113 (6), p.490-493
Main Authors: Luceri, Patricia M, Haenel, 4th, Louis C
Format: Article
Language:English
Subjects:
Aged
Biopsy, Needle
Calcium - blood
Diagnosis, Differential
Fatal Outcome
Female
Follow-Up Studies
Humans
Hypercalcemia - blood
Hypercalcemia - diagnosis
Hypercalcemia - etiology
Lymphoma, B-Cell - complications
Lymphoma, B-Cell - diagnosis
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Summary:The authors report a case of hypercalcemia in a 79-year-old woman that led to multiple hospitalizations. The case was challenging because the hypercalcemia was ultimately found to have 2 distinct causes. The patient initially presented with an elevated parathyroid hormone (PTH) level, consistent with primary hyperparathyroidism. She underwent parathyroidectomy and her hypercalcemia resolved in the immediate postoperative period. Four days after the operation, she was found to have recurrent hypercalcemia with a suppressed PTH level, raising suspicion for hypercalcemia of malignancy. After an extensive workup, the patient was found to have lymphoma, which was causing hypercalcemia and suppressing PTH. The authors also review the literature on hypercalcemia of malignancy.
ISSN:0098-6151
1945-1997