J Korean Soc Endocrinol.  2006 Jun;21(3):251-256. 10.3803/jkes.2006.21.3.251.

A Case of Hyperthyroidism Associated with Symptomatic Hypercalcemia

• Choi JH
• Lee WJ
• Chung YH
• Park HW
• Lee DB
• Won JC
• Kim DJ
• Kim GS

• KMID: 2200738
• DOI: http://doi.org/10.3803/jkes.2006.21.3.251

Abstract

Two of the common causes of hypercalcemia are malignancy and primary hyperparathyroidism. These disorders are easily diagnosed by the clinical manifestations and measurement of the serum intact parathyroid hormone (PTH) level. On the other hand, hyperthyroidism is an uncommon cause of hypercalcemia. The diagnosis of hypercalcemia associated with hyperthyroidism can only be made by excluding the common causes of hypercalcemia and by observing the improvement of the hypercalcemia and its associated symptoms with normalizing the thyroid function. Herein we reported our experience with a 67 year-old woman who presented with nausea and vomiting. She showed elevated serum calcium and phosphorus levels. Serum intact PTH level was 1.1 pg/mL (normal range; 10~65). The results of the thyroid function test were compatible with hyperthyroidism. After resolution of the thyrotoxicosis with combination treatment of methimazol and Lugol's solution, the patient's serum calcium and phosphorus levels were normalized and the symptoms were improved.

MeSH Terms

Aged
Calcium
Diagnosis
Female
Graves Disease
Hand
Humans
Hypercalcemia*
Hyperparathyroidism, Primary
Hyperphosphatemia
Hyperthyroidism*
Nausea
Parathyroid Hormone
Phosphorus
Thyroid Function Tests
Thyroid Gland
Thyrotoxicosis
Vomiting
Calcium
Parathyroid Hormone
Phosphorus

Figure

• 

  Fig. 1 Bone mineral density at initial diagnosis.

• 

  Fig. 2 Technetium-99m thyroid scan shows diffuse enlargement with homogenous increased uptake of 16.1%.

• 

  Fig. 3 Serial measurements of calcium and phosphorous.

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