Hypercalcemia and High Bone Mineral Density

Hirotaka Miyashita, Se Min Kim, John G. Graham

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

A 69-year-old African American woman is evaluated for intermittent hypercalcemia for many years. Initial work-up demonstrated normal calcium, elevated PTH, and low vitamin D 25-OH, which suggest primary versus secondary hyperparathyroidism. Upon repletion of vitamin D, PTH remained elevated, and calcium levels rose, demonstrating that secondary hyperparathyroidism from vitamin D deficiency can intermittently mask primary hyperparathyroidism and hypercalcemia. To determine surgical candidacy, bone densitometry was done, which demonstrated significantly high bone mass of axial bone or osteopetrosis, an unexpected finding in patients with primary hyperparathyroidism which typically causes catabolic bone loss and osteoporosis. In this rare presentation of high bone mass concomitant with primary hyperparathyroidism, we discuss possible causes of acquired osteopetrosis and inherited sclerosing skeletal dysplasia and methods to differentiate complex cases of hypercalcemia and parathyroid disease.

Original languageEnglish
Title of host publicationA Case-Based Guide to Clinical Endocrinology, Third Edition
PublisherSpringer International Publishing
Pages243-249
Number of pages7
ISBN (Electronic)9783030843670
ISBN (Print)9783030843663
DOIs
StatePublished - 1 Jan 2022

Keywords

  • High bone mass
  • Hypercalcemia
  • LRP5
  • Osteopetrosis
  • Primary hyperparathyroidism

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