A case of hypercalcemia with double pathology

Abstract

Hypercalcemia has many causes including primary hyperparathyroidism, malignancy, and other rare etiologies. In most of the cases, hypercalcemia is secondary to one etiology. In this case, we are reporting hypercalcemia with two causes. The initial workup showed primary hyperparathyroidism due to parathyroid adenoma. But because all features were not fully explained by primary hyperparathyroidism, further work-up revealed multiple myeloma. This case represents coexistence of two different diseases, which was rarely reported in the literature previously. Usually, the co-diagnosis was made subsequently after failure to correct hypercalcemia. In our case, both diagnoses were established at the same time of the patient’s presentation as of high suspicion. Establishing the diagnosis early will aid in the initiation of treatment in a timely fashion.

Hypercalcaemia, adrenal insufficiency and bilateral adrenal histoplasmosis in a middle-aged man: a diagnostic dilemma

“…While primary hyperparathyroidism is the most common cause in ambulatory patients, malignancy remains the most common aetiology in hospitalised patients 1. Rarely, two causes of hypercalcaemia (such as primary hyperparathyroidism and multiple myeloma) may coexist in a given patient 2 3. This should be suspected in patients with difficult-to-control hypercalcaemia, where a single aetiology fails to explain all the clinical and laboratory findings.…”

Should We Consider Primary Hyperparatyroidism in Multiple Myeloma Cases with Hypercalcemia

“…rülen ve sıklıkla atlanabilecek bir durumdur. Literatürde şu ana kadar yaklaşık 30 olguda PHP ve MM birlikteliği bildirilmiştir (2,3). Bu olguların bir kısmında öncelikle MM'ye bağlı olduğu düşünülen hiperkalsemi tedavi edilmeye çalışılmış, ancak hiperkalseminin kontrol altına alınamaması üzerine beraberinde PHP tanısının varlığı gösterilebilmiştir.…”