Endocrine Abstracts

Introduction: Chronic liver disease (CLD) is usually not described as a common cause of hypercalcemia unless there is hepatoma. Of late, there are some reports suggesting CLD as a cause for hypercalcemia. The exact mechanism contributing to hypercalcemia in CLD is poorly understood. It usually correlates with the severity of disease.

Aim of the study: To assess the prevalence of hypercalcemia in patients with chronic liver disease To study the relation of hypercalcemia to the severity and duration of chronic liver disease.

Materials and Methods: Patients getting hospitalised with chronic liver disease in a tertiary referral centre between 2016 and 2018 were included in the study. Patients with known hypercalcemic disorders, malignancies and those on active Vitamin D supplements were excluded. Besides Liver function tests, Prothrombin time and AFP, Corrected Calcium estimation was done in all patients. In patients who had corrected Calcium>10.5 mg/dl, Parathyroid hormone and Vitamin D assays were performed. Patients who were found to have hypercalcemia were followed up for next 1 year.

Results: 251 patients participated in the study. 24 patients (9.6%) was found to have hypercalcemia. 3 /24 had hyperparathyroidism. In the rest, 21 patients, no definitive etiology was found. Hypercalcemia was attributed to chronic liver disease. Majority of the patients (76%) in the hypercalcemia group had Child C score, while only 25% in the non hypercalcemia group had Child C score. The mean bilirubin level was significantly high in hypercalcemic group when compared to non hypercalcemic group (6.67mg/dl vs 2.16 mg/dl). There was no significant renal dysfunction among patients with hypercalcemia compared to patients with normocalcemia.

Conclusion: Hypercalcemia is fairly common among patients with advanced CLD. It correlates well with the severity of liver disese and bilirubin levels.