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

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Abstract

We describe an elderly man who presented with hypercalcemia associated with suppressed intact parathyroid hormone (PTH) levels. Despite renal insufficiency the circulating 1,25-di-hydroxyvitamin 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.

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Authors and Affiliations

  1. Department of Medicine, St. Luke’s Medical Center, HS # 503, 2901 West Kinnickinnic River Parkway, Milwaukee, WI, 53215, USA

    Joseph L. Shaker M.D., G. E. Auger & J. W. Findling

  2. Department of Orthopedic Surgery, St. Luke’s Medical Center, Milwaukee, WI, USA

    P. P. Wendt

Authors
  1. Joseph L. Shaker M.D.
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  2. G. E. Auger
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  3. P. P. Wendt
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  4. J. W. Findling
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Additional information

Presented in part at the Sixth Annual Meeting of the Adult Bone and Mineral Working Group (American Society for Bone and Mineral Research Meeting), San Diego, California, 1991.

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Shaker, J.L., Auger, G.E., Wendt, P.P. et al. Hypercalcemia associated with dysregulation of 1,25-dihydroxyvitamin D in arthritis. J Endocrinol Invest 15, 771–776 (1992). https://doi.org/10.1007/BF03347650

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  • DOI: https://doi.org/10.1007/BF03347650

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