Endocrine Abstracts

Objective

To describe a few cases of patients presenting with various unusual causes of hypercalcaemia to a District General Hospital.

Methods

Three case histories, including detailed results of laboratory tests, are presented, and the findings are discussed.

Results

In the first case we describe an eighty year old patient recently started on lithium carbonate for manic-depressive illness. She was admitted with lithium overdose. Initial investigations showed high calcium levels which reversed on stopping lithium. Our next patient is a sixty six year old lady who way back in 1996 was diagnosed with skin sarcoidosis. She was then admitted to hospital in 2005 complaining of constipation, polyuria and frequent bone pains. Her calcium level was 3.75 mmol/l. Her calcium levels normalized on initiation of steroid treatment. Our final case describes a seventy five year old gentleman known to suffer from hypertension. In 2003, after suffering an inferior MI, he was started on indapamide for his uncontrolled hypertension. He was referred to the Endocrinology Clinic in 2005 after he was found to have a high calcium level. This was associated with a high PTH level both of which improved on cessation of indapamide. To our knowledge this is the first recorded case of indapamide induced hyperparathyroidism.

Conclusion

Hypercalcaemia is a common metabolic condition encountered in both inpatient and outpatient settings. Physicians can more successfully diagnose and treat patients with hypercalcaemia by being aware of the so many different types of aetiologies for this metabolic abnormality. Effective treatment options can then be implemented.