Endocrine Abstracts

We present the case of a 58 years old woman with a long history of Graves’ disease and mild hypercalcaemia (total calcium registered a maximum of 11.1 mg/dl) that was first interpreted as a consequence of hyperthyroidia. After 10 year of being treated with anti-thyroid drugs the patient finally decides to undergo surgery. Immediately after surgery this particular patient does not develop hypoparathyroidism, her calcium level remaining a little high. Six weeks after surgery under appropriate thyroid supplementation the calcium levels still remains a little high (10.8 mg/dl). The labs also show normal phosphate, with normal alkaline phosphatase, normal PTH, normal renal function. Other causes of hypercalcaemia were also excluded. We raised the suspicion of a FHH although the patient did not have any familial history. We found hypercalciuria (3 mg/24 h) and a low calcium/creatinine clearance (0.002) witch sustain our supposition. After that we started searching the same disease in the family but unfortunately we were only able to find it in her only son, her parents being already dead and she does not any other siblings. What also intrigued us in this patient is the bone density witch is not normally affected in FHH but here we found a poor mineral density (especially on radius of Ts=−3.4) which we interpreted as being due to the long evolution of hyperthyroidism. In conclusion we describe the case of FHH in a woman with Graves’ disease in which hypercalcaemia was initially attributed to hyperthyroidism.