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- Title
Elderly patient presenting with severe thyrotoxic hypercalcemia.
- Authors
Kikuchi, Reiko; Mochizuki, Satoru; Shimizu, Masahiko; Sudoh, Noriko; Kozaki, Koichi; Akishita, Masahiro; Toba, Kenji
- Abstract
An 81-year-old woman with Graves’ disease and osteoporosis was referred to the hospital because of anorexia over one month and impaired consciousness. She also presented with low-grade fever and emaciation. Laboratory tests revealed marked hypercalcemia (corrected serum calcium level of 12.4 mg/dL), which was initially suspected to result from vitamin D toxicity, because she had been taking vitamin D3 (alphacalcidol of 0.5 µg/day) for the treatment of osteoporosis. However, discontinuation of vitamin D3 and fluid infusion did not ameliorate hypercalcemia one week later. After excluding hyperparathyroidism and malignancy-related hypercalcemia, hypercalcemia was considered to be attributable to the exacerbation of hyperthyroidism (free T4 of 6.69 ng/dL, free T3 of 13.27 pg/mL and thyroid stimulating hormone (TSH) <0.015 µIU/mL) with increased bone resorption. Finally, the increased dose of thiamazole (30 mg/day) normalized serum calcium level and thyroid function three months later. Laboratory tests suggested that normal bone formation in spite of increased bone resorption contributed to hypercalcemia in hyperthyroid state.
- Subjects
DISEASES in older women; HYPERCALCEMIA; HYPERTHYROIDISM; CHOLECALCIFEROL; BONE resorption
- Publication
Geriatrics & Gerontology International, 2006, Vol 6, Issue 4, p270
- ISSN
1444-1586
- Publication type
Article
- DOI
10.1111/j.1447-0594.2006.00359.x