Endocrine Abstracts

Background: Immobilisation hypercalcaemia is serious complication of prolonged immobility of any cause such as spinal cord injury, polio victims, burns victims, as well as trauma patients.

Case: Eighteen-years old student was admitted to the hospital following road traffic accident. He sustained multiple fractures, skull, spine, chest and pelvis. He also sustained abdomen and pelvic haematoma. At scene of crash he had GCS 5/15, needing intubation and was aiirlifted to trauma centre, where he underwent extensive surgery laparatomy and pre-peritoneal packing, reduction of fracture dislocation of right, open reduction and fixation of bilateral pelvics fracture and acetabulum. His past medical includes orchidectomy after failed orchidopexy, and epistaxisis. After that he was transferred to his local Hospital for rehabilitation. His bloods showed Na⁺ 143, K 3.3, creatinine 45, calcium 3.01, PTH 0.9 pmol/l, 24 h urinary calcium 15.1 mmol/l vitamin D 46 phosphate 1.08, ALP 95, AST 45, Hb 12. He had normal calcium (2.25 mmol/l) during his initial admission to the trauma centre.

He was treated with i.v. fluids and pamidronate 30 mg single dose and his calcium level normalise. His calcium remains normal and the patient is undergoing physiotherapy.

Discussion: Immobilisation hypercalcaemia is a common complication of prolonged immobility of different causes including road traffic accident. Although well described among young patients with spinal cord it may happen in immobile patients following road traffic accident as demonstrated in our case report. It usually develops 1–16 weeks post trauma, and it may remain elevated up to 12 months.

Conclusion: Prolonged immobility following road traffic accident may cause hypercalcaemia which is reversible.