%0 Journal Article
%T Challenges in the differential diagnosis of hypercalcemia: A case of hypercalcemia with normal PTH level
%A Francesca Pellicciotti
%A Andrea Giusti
%A Maria Carolina Gelli
%A Salvatore Foderaro
%J World Journal of Clinical Oncology
%D 2012
%I Baishideng Publishing Group Co. Limited
%R 10.5306/wjco.v3.i1.7
%X The hypercalcemias are a common and heterogeneous group of disorders, ranging from the occasional detection of a high level of serum calcium to a life-treating condition. In a patient presenting with hypercalcemia, a differential diagnosis can be established easily by measuring serum calcium and parathyroid hormone (PTH) concentrations. We describe the case of an 83-year-old man presenting with a severe symptomatic hypercalcemia with high-normal PTH level due to the coexistence of primary hyperparathyroidism and malignancy-associated hypercalcemia. The presence of two conditions producing hypercalcemia was revealed only during in-hospital stay and after the administration of an intravenous bisphosphonate, when the PTH concentration increased rapidly after bisphosphonate treatment with a decrease in serum calcium. The occurrence of two conditions producing hypercalcemia is a rare event in the literature, and should be considered in the presence of an abnormally high serum calcium level associated with normal or high-normal PTH, in order to establish a correct diagnosis and appropriate interventions.
%K Bisphosphonates
%K Hypercalcemia
%K Malignancy-associated hypercalcemia
%K Parathyroid hormone
%K Primary hyperparathyroidism
%U http://www.wjgnet.com/2218-4333/full/v3/i1/7.htm