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Journal of Clinical Endocrinology & Metabolism, Vol 71, 1305-1309, Copyright © 1990 by Endocrine Society

ARTICLES

Primary hyperparathyroidism and severe hypercalcemia with low circulating 1,25-dihydroxyvitamin D

JL Shaker, KW Krawczyk and JW Findling
Department of Medicine, St. Luke's Medical Center, Milwaukee, Wisconsin 53215.

We report a postmenopausal woman with primary hyperparathyroidism (PHPT) and severe hypercalcemia while her total calcium intake was more than 2 g daily. Despite a markedly elevated intact PTH level, her serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] level was low (17 pmol/L; 7 pg/mL). With reduced calcium intake, her serum calcium normalized, and 1,25-(OH)2D increased to 122 pmol/L (51 pg/mL). At the same time, intact PTH decreased to 32% of the initial value. PHPT may be associated with low circulating 1,25-(OH)2D levels. Furthermore, low 1,25-(OH)2D levels in PHPT may be due to a direct effect of severe hypercalcemia and be reversible with correction of hypercalcemia.


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