Hypercalcemia associated with dysregulation of 1,25-dihydroxyvitamin D in arthritis

We describe an elderly man who presented with hypercalcemia associated with suppressed intact parathyroid hormone (PTH) levels. Despite renal insufficiency the circulating 1,25-dihydroxyvitamin D (1,25(OH)2D) was in the upper part of the normal range. Known causes of hypercalcemia were absent and mi...

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Bibliographic Details
Published inJournal of endocrinological investigation Vol. 15; no. 10; p. 771
Main Authors Shaker, J L, Auger, G E, Wendt, P P, Findling, J W
Format Journal Article
LanguageEnglish
Published Italy 01.11.1992
Subjects
Aged
Arthritis - complications
Arthritis - metabolism
Dihydroxycholecalciferols - metabolism
Hip Prosthesis
Humans
Hypercalcemia - complications
Hypercalcemia - metabolism
Male
Monocytes - metabolism
Parathyroid Hormone - blood
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Summary:We describe an elderly man who presented with hypercalcemia associated with suppressed intact parathyroid hormone (PTH) levels. Despite renal insufficiency the circulating 1,25-dihydroxyvitamin D (1,25(OH)2D) was in the upper part of the normal range. Known causes of hypercalcemia were absent and mild hypercalcemia with suppression of intact PTH persisted until after bilateral hip replacement for severe arthritis (1 year after presentation). After hip replacement the ionized calcium normalized, intact PTH normalized, and 1,25(OH)2D decreased markedly. We believe the abnormalities in mineral homeostasis were related to production of 1,25(OH)2D by inflammatory mononuclear cells associated with arthritis.
ISSN:0391-4097
1720-8386
DOI:10.1007/BF03347650