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Horm Metab Res 2021 Jun 21;53(6):377-381. Epub 2021 Jun 21.

Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab, India.

Acute pancreatitis as an initial manifestation of primary hyperparathyroidism (PHPT) is a rare occurrence and timely diagnosis of PHPT is crucial in preventing repeat attack of pancreatitis. The study aimed at evaluating the clinico-radiological profile of patients admitted with acute pancreatitis as the index presentation of PHPT and to determine the factors associated with development of severe pancreatitis. This series included retrospective analysis of medical records of 30 patients admitted with acute pancreatitis as initial manifestation of PHPT. Read More

Endocrinol Diabetes Metab Case Rep 2021 Jun 1;2021. Epub 2021 Jun 1.

Department of Endocrinology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.

Summary: Marfan syndrome is an autosomal dominant multisystem disorder that has an estimated incidence of 1 in 5000. It is caused by mutations in the FBN1 gene, which encodes the extracellular matrix protein type 1 fibrillin. Familial hypocalciuric hypercalcaemia (FHH), also inherited in an autosomal dominant pattern, is a rare benign disorder characterised by hypercalcaemia, hypocalciuria and relative hyperparathyroidism with normal or high plasma PTH levels, with an estimated incidence of between 1 in 10 000 to 1 in 100 000. Read More

Endocrinol Diabetes Metab Case Rep 2021 Jun 1;2021. Epub 2021 Jun 1.

Endocrinology and Diabetes, Mid-Yorkshire NHS Trust, Wakefield, England.

Summary: Primary hyperparathyroidism (PHPT) is a disease caused by overactive parathyroid glands with consequent hypercalcaemia. The main cause in 85-90% of the cases is the presence of a solitary parathyroid adenoma. The most common presentation is with asymptomatic hypercalcaemia diagnosed on routine biochemical testing. Read More

Intern Med 2021 Jun 19. Epub 2021 Jun 19.

Department of Nephrology, University of Fukui, Japan.

A 78-year-old man presented with hypercalcemia and renal disease with high serum IgG4 and positive myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA), exhibiting sarcoidosis-like chest findings. A renal biopsy revealed tubulointerstitial nephritis, membranous nephropathy (MN), and sub-capsular lymphoid aggregates without fulfilling the diagnostic criteria of IgG4-related disease or sarcoidosis. Steroid therapy ameliorated the serological and renal abnormalities. Read More

Pediatr Dermatol 2021 Jun 18. Epub 2021 Jun 18.

Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Subcutaneous fat necrosis (SCFN) is an inflammatory disorder of the adipose tissue that commonly presents in neonates as tender subcutaneous nodules on the trunk and extremities with hypercalcemia as a potential complication. We report the case of a 3-month-old female who presented with circular alopecia of the scalp and was found to have histopathologically confirmed SCFN. Recognition of SCFN as a cause for alopecia in young infants may allow prompt screening for hypercalcemia and reduce the risk for associated morbidity and mortality. Read More

Endocr Pract 2021 Jan 16. Epub 2021 Jan 16.

Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Objective: To determine whether tumor volume and tumor size are related to disease severity in parathyroid cancer (PC).

Methods: Patients treated for PC at our institution were retrospectively identified. Data were collected about clinical and pathologic characteristics, laboratory parameters, tumor volume, recurrence, metastasis, and mortality. Read More

Exp Clin Transplant 2021 Jun 17. Epub 2021 Jun 17.

From the Department of Internal Medicine, School of Medicine, Ege University, Izmir, Turkey.

Pneumocystis jirovecii pneumonia is an opportunistic infection in kidney transplant recipients. It may be complicated by hypercalcemia. Here, we discuss a 59-year-old man who presented with respiratory symptoms and hypercalcemia. Read More

Curr Opin Endocr Metab Res 2021 Feb 2;16:10-28. Epub 2020 Jul 2.

Institute of Metabolism and Systems Research (IMSR) and Centre for Diabetes, Endocrinology and Metabolism (CEDAM), University of Birmingham, Birmingham, B15 2TT, UK.

The calcium-sensing receptor (CaSR) is a class C G-protein-coupled receptor (GPCR) that plays a fundamental role in extracellular calcium homeostasis by regulating parathyroid hormone (PTH) release. Although the CaSR was identified over 25 years ago, new mechanistic details of how the CaSR controls PTH secretion have recently been uncovered demonstrating heteromerization and phosphate binding affect CaSR-mediated suppression of PTH release. In addition, understanding of how the CaSR performs diverse functions in different cellular contexts is just beginning to be elucidated, with new evidence of tissue-specific regulation, and endo-somal signaling. Read More

Leuk Res Rep 2021 24;15:100252. Epub 2021 May 24.

Hotel Dieu de France University Hospital, Faculty of Medicine, University of Saint Joseph, Beirut, Lebanon.

Objective: The present retrospective multicenter study aims at documenting characteristics of multiple myeloma (MM) patients and the effect of autologous stem cell transplant (ASCT) on survival.

Methods: A total of 134 adult patients initiating any new MM therapy from January 2002 till December 2019 were included. Enrollment was stratified by disease subtype, induction protocol and transplant status. Read More

Cureus 2021 Jun 4;13(6):e15440. Epub 2021 Jun 4.

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Multiple myeloma (MM) is a hematological malignancy characterized by renal insufficiency, bone lesions, anemia, and hypercalcemia. In this modern era of medicine, even with the development of drugs like immunomodulatory agents (IMiDs) and proteasome inhibitors (PI), the treatment of MM prevails as a challenge. However, even after the attainment of total remission, relapse of MM and disease progression is frequent. Read More

J Clin Endocrinol Metab 2021 Jun 17. Epub 2021 Jun 17.

Department of Pediatrics, Division of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Context: Idiopathic Infantile Hypercalcemia (IIH) is an uncommon disorder with variable clinical features. The natural history and response to dietary calcium and vitamin D restriction in IIH remains unclear.

Objective: The aim of this study is to describe the clinical and biochemical response to dietary calcium and vitamin D restriction in a genetically characterized cohort of mild IIH. Read More

Osteoporos Int 2021 Jun 17. Epub 2021 Jun 17.

Health Care Division, Health and Counseling Center, Osaka University, Osaka, Japan.

Our human observational study showed that elevated arginine vasopressin levels by heavy exercise, not catecholamines, were associated with elevated serum tartrate-resistant acid phosphatase 5b (TRACP-5b). The increase in serum calcium was positively associated with percent changes of TRACP-5b, implying the involvement of bone resorption in the pathogenesis of exercise-induced hypercalcemia.

Introduction: It remains unclear whether enhanced bone resorption explains exercise-induced hypercalcemia. Read More

Medicina (B Aires) 2021 ;81(3):462-466

Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile. E-mail:

PTH-independent hypercalcemia due to granulomatous disease is well-documented and sarcoidosis is the most characteristic disease, although there are others. We describe a case of sarcoid-like granulomatous myositis. An 87-year-old man was referred with tetraparesis and hypercalcemia (albumin-corrected calcium of 13. Read More

Mini Rev Med Chem 2021 Jun 16. Epub 2021 Jun 16.

Department of Chemistry, Faculty of Food Technology, University of Agriculture, Kraków, Poland.

It is estimated that by 2040 Chronic Kidney Disease (CKD) will be the 5th main cause of global deaths. It has been suggested that hyperphosphatemia is among the main factors leading to the increased risk of death. This review focuses on potential and currently used phosphate binders (PB). Read More

J Clin Endocrinol Metab 2021 Jun 14. Epub 2021 Jun 14.

Division of Endocrinology and Diabetes and Center for Bone Health, Children's Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States.

Context: Idiopathic Infantile Hypercalcemia (IIH), an uncommon disorder characterized by elevated serum concentrations of 1,25(OH)2D and low PTH levels, may present with mild to severe hypercalcemia during the first months of life. Biallelic variants in the CYP24A1 or SLC34A1 genes are associated with severe IIH. Little is known about milder forms. Read More

Head Neck 2021 Jun 14. Epub 2021 Jun 14.

Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan, USA.

Background: The development of primary hyperparathyroidism (PHPT) after radioactive iodine (RAI) treatment for thyroid disease is poorly characterized. The current study is the largest reported cohort and assesses the disease characteristics of patients treated for PHPT with a history of RAI exposure.

Methods: A retrospective analysis comparing patients, with and without a history of RAI treatment, who underwent surgery for PHPT. Read More

J Family Med Prim Care 2021 Apr 29;10(4):1785-1788. Epub 2021 Apr 29.

College of Medicine Chattanooga, The University of Tennessee Health Science Center, Chattanooga, TN 37403, USA.

We report a case of a 51-year-old male with minimal past medical history who presented to his primary care provider with nausea, vomiting and constipation in the outpatient setting. Concomitantly, he was found to have a renal injury, anemia and lytic lesions which were confirmed to be due to multiple myeloma. After further investigation of the gastrointestinal symptoms, he was diagnosed with gastroparesis. Read More

Med Clin (Barc) 2021 Jun 8. Epub 2021 Jun 8.

Department of General and Digestive Surgery. Hospital Universitario Virgen de Valme, Sevilla, Spain.

Stem Cell Res 2021 Jun 4;54:102414. Epub 2021 Jun 4.

Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia.

Neonatal severe primary hyperparathyroidism (NSHPT) is a rare autosomal recessive disorder of calcium homeostasis that manifests shortly after birth with hypercalcemia and bone disease. NSHPT, in most cases, is attributed to mutations in the calcium-sensing receptor (CASR) gene. We reprogrammed dermal fibroblasts derived from a patient with NSHPT carrying a compound heterozygous mutation in the CASR gene into induced pluripotent stem cells (iPSCs). Read More

Endocrinol Diabetes Metab Case Rep 2021 Jun 1;2021. Epub 2021 Jun 1.

Department of Endocrinology, Austin Health, Victoria, Australia.

Summary: Hypercalcaemia is a very common endocrine condition, yet severe hypercalcaemia as a result of fungal infection is rarely described. There are have only been two reported cases in the literature of hypercalcaemia associated with Cryptococcus infection. Although the mechanism of hypercalcaemia in these infections is not clear, it has been suggested that it could be driven by the extra-renal production of 1-alpha-hydroxylase by macrophages in granulomas. Read More

Case Rep Endocrinol 2021 20;2021:5551203. Epub 2021 May 20.

Milton Keynes University Hospital, Standing Way, Eaglestone, Milton Keynes MK6 5LD, UK.

Hypercalcaemia and its systemic sequelae are a relatively common finding amongst patients in the field of endocrinology. Primary hyperparathyroidism, a frequent cause of hypercalcaemia, is often seen among middle-aged female patients, typically resulting from an underlying single-gland adenoma. Although patients may present with symptoms (nephrolithiasis, musculoskeletal discomfort, dehydration, or mood disturbance, to name a few), hypercalcaemia is rather frequently identified incidentally. Read More

J Ren Nutr 2021 Jun 5. Epub 2021 Jun 5.

Division of Nephrology & Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH.

Objective: Hypervitaminosis A is well-described but overlooked in chronic kidney disease (CKD) and has been associated with hypercalcemia, contributing to mineral bone disease. Our objective is to assess prevalence of hypervitaminosis A and its association with bone health in an advanced-CKD population.

Methods: We performed a retrospective review of 58 children with CKD 4-5 to examine the association between vitamin A levels and bone health and compared these values between a primarily formula-fed (FF) and nonprimarily formula-fed cohort (NFF). Read More

AACE Clin Case Rep 2021 May-Jun;7(3):200-203. Epub 2021 Jan 19.

Division of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Introduction: Hypercalcemia of malignancy (HCM) portends a very poor prognosis, and no established guidelines exist regarding its management. Most instances of HCM are due to local osteolysis or secretion of parathyroid hormone related-peptide, while less than 1% of all cases are due to ectopic secretion of parathyroid hormone.

Case Report: We present an unusual case of HCM due to proposed cosecretion of both parathyroid hormone and parathyroid hormone-related protein in a 36-year-old man with a poorly differentiated lung adenocarcinoma. Read More

AACE Clin Case Rep 2021 May-Jun;7(3):189-191. Epub 2020 Dec 19.

Valleywise Behavioral Health- Maryvale, 5102 W Campbell Ave, Phoenix, Arizona.

Objective: To familiarize the medical community with the less common adverse effects of lithium on parathyroid function, we present a case of lithium-associated hyperparathyroidism followed by the development of new-onset catatonia in a patient with schizoaffective disorder.

Methods: To allow for the safe resumption of lithium, the patient received laboratory screening of serum lithium, blood urea nitrogen, serum creatinine, calcium, and thyroid-stimulating hormone levels. The hypercalcemia was evaluated by measuring parathyroid hormone (PTH), ionized calcium, and 25-hydroxy vitamin D levels. Read More

AACE Clin Case Rep 2021 May-Jun;7(3):169-173. Epub 2021 Jan 7.

Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.

Objective: Hypercalcemia is a common finding in patients who have an underlying malignancy. Only a few cases of hypercalcemia of malignancy have been linked to more than one mechanism of hypercalcemia. Here, we present a patient with liposarcoma and hypercalcemia of malignancy in the setting of simultaneous elevations in parathyroid hormone-related peptide (PTHrP) and 1,25 dihydroxyvitamin D [1,25(OH)D] levels. Read More

AACE Clin Case Rep 2021 Mar-Apr;7(2):113-116. Epub 2020 Dec 28.

Department of Endocrinology, Diabetes & Metabolism, Walter Reed National Military Medical Center, Bethesda, Maryland.

Objectives: Renal papillary necrosis (RPN) occurring in primary hyperparathyroidism (PHPT) has not been reported. We present a 50-year-old woman who manifested RPN associated with hypercalciuria and normocalcemic PHPT.

Methods: The diagnosis of RPN was based on imaging studies (ultrasound and computed tomography [CT] scan). Read More

Front Endocrinol (Lausanne) 2021 19;12:665698. Epub 2021 May 19.

Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.

Background: Hypercalcemia is a common paraneoplastic syndrome which can occur in up to 10% of patients with advanced neoplasms. Paraneoplastic parathyroid hormone-related protein (PTHrP) represents the most frequent cause of this syndrome. In neuroendocrine neoplasms (NENs) paraneoplastic hypercalcemia is rare. Read More

Intern Med J 2021 Jun 6. Epub 2021 Jun 6.

Department of Endocrinology, Royal Prince Alfred Hospital, New South Wales, Australia.

Background: Studies examining hypercalcaemia in inpatients were largely published over 20 years ago, and it is likely the epidemiology of hypercalcaemia has changed related to increased lifespan and changes in prevalence of the underlying causes such as malignancy.

Aim: To explore the epidemiology of hypercalcaemia in a modern tertiary hospital setting in Australia, and evaluate the risk of mortality associated with hypercalcaemia.

Method: A retrospective study was performed in all inpatients with elevated blood calcium levels admitted from July 2013 to June 2018. Read More

Osteoporos Int 2021 Jun 3. Epub 2021 Jun 3.

Rheumatology department, Ibn Rochd University Hospital, Hassan II University of Medecine and Pharmacy, Casablanca, Morocco.

Zoledronic acid, an amino-bisphosphonate, is an antiresorptive drug given intravenously. It is commonly used for the treatment of severe postmenopausal osteoporosis, and it is also used for other types of osteoporosis, management of bone metastasis, multiple myeloma, hypercalcemia, and Paget's disease. The use varies according to these diseases. Read More

Acta Endocrinol (Buchar) 2020 Oct-Dec;16(4):497-500

"Dr. Ram Manohar Lohia" Hospital, Department of Endocrinology, New Delhi, India.

Objective: Ectopic parathyroid adenoma is an uncommon cause of primary hyperparathyroidism. Apart from the usually described sites of ectopic parathyroid adenoma, anecdotal case reports of undescended parathyroid adenoma along the carotid artery have been described.

Methods: We report a rare case of a 4 cm large parathyroid adenoma within the carotid sheath. Read More