ArticleBMJ case reports2021
Severe hypercalcaemia secondary to relapsed Graves' disease.
Article in BMJ case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Exploring Thyrotoxic Hypercalcaemia Through Two Cases: A Myriad of Uncertainties.Case reports in endocrinology · 2026Article
- Article
- Non-parathyroid hypercalcemia in a patient with new-onset hyperthyroidism and silicone-induced granulomas: case report.Frontiers in endocrinology · 2024Article
- Hypercalcaemia as the initial presentation of Graves' disease.BMJ case reports · 2022Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A 21-year-old woman presented to hospital with abdominal pain and nausea. She had a history of Graves' disease which had been effectively treated with carbimazole for 15 months. Investigations revealed a serum adjusted calcium level of 3.69 mmol/L with a suppressed parathyroid hormone, thyroid stimulating hormone <0.01 mu/L (0.2-5.0) and free T4 of 76.1 pmol/L (9-24). She was treated as a relapsed case of Graves' disease and started on propylthiouracil. Calcium levels continued to increase over the next 3 days despite adequate fluid resuscitation. A decision was taken to administer intravenous bisphosphonate (pamidronate) which resulted in a lowering of calcium levels. She became mildly hypocalcaemic following treatment with pamidronate which was presumed secondary to low vitamin D and oral vitamin D replacement was commenced. This case was unique as this is to our knowledge the most significant hypercalcaemia observed in a patient with hyperthyroidism. All other causes of hypercalcaemia were excluded. The learning points were recognising hypercalcaemia as a complication of thyrotoxicosis and the risk of hypocalcaemia following bisphosphonate therapy with low vitamin D stores.
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