Primary Hyperparathyroidism Masquerading as Immobilization Hypercalcemia

Endocrine Journal

YUTAKA MIZUSHIMA¹  JUN NAKAYAMA⁴  HIROMI KATO¹  MASASHI KOBAYASHI¹  SATOSHI MONNO¹  SEIJI OHGAKU¹  NOBUUKI TAKASU²  TAMOTSU YOKOZAWA³ 

[1] First Department of Internal Medicine, School of Medicine, Toyama Medical and Pharmaceutical University;Department of Gerontology, Endocrinology and Metabolism, School of Medicine, Shinshu University;Department of Surgery, Iiyama Red Cross Hospital;Central Clinical Laboratories, Shinshu University Hospital

关键词: Immobilization;    Hyperparathyroidism;    Hypercalcemia;    Parathyroid hormone assay;   

DOI  :  10.1507/endocrj.40.35

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(14)Cited-By(1)We report a male who exhibited the Landry-Guillain-Barré syndrome and hypercalcemia. He initially exhibited normocalcemia, followed by hypercalcemia which developed during tetraplegi a and the recovering phase of the syndrome. The administration of prednisolone, saline, calcitonin, etidronate, and indomethacin failed to normalize the serum calcium level. Since, with mobilization, the serum calcium level gradually became normal, the calcium abnormality was misdiagnosed as immobilization hypercalcemia. However, among 6 different parathyroid hormone (PTH) assays used, including a two-site immunoradiometric assay, only a mid-region specific PTH (mPTH) assay showed high levels in both hypercalcemic and normocalcemic periods, and a high level of mPTH was not suppressed by calcium infusion in the normocalcemic period. Neck exploration disclosed a parathyroid adenoma weighed 100mg. This case illustrates the hypercalcemia-inducing effect of immobilization on mild type primary hyperparathyroidism. A high level mPTH assay, its unsuppressibility by the calcium infusion test, and ineffectiveness of oral etidronate for hypercalcemia were valuable in differentiating hypercalcemia due to primary hyperparathyroidism from that resulting solely from prolonged immobilization.

【 授权许可】

Unknown