A 37-year-old man with no significant past medical history was referred to the emergency department due to severe and sudden onset back pain. He also complained of weakness, nausea, and an episode of vomiting in the last 3 days. On examination he appeared ill with dry mucous membranes and poor skin turgor. He weighed 59 kg and had a height of 1.73 m (body mass index 19.7). He had a blood pressure of 130/80 mmHg, heart rate of 90 beats per min, temperature of 36.6 degrees Celsius, and O2 saturation of 99%. On palpation, marked tenderness was elicited over the right posterior aspect of the rib cage and small (up to 1 cm) but firm lymph nodes were palpated in the inguinal region bilaterally. Blood tests revealed hypercalcemia of 22.3 mg/dL and undetectable parathyroid hormone levels, creatinine of 1.6 mg/dL, urea of 63 mg/dL, and phosphorus of 4.4 mg/dL. He was treated with intravenous saline followed by furosemide, intravenous pamidronate and subcutaneous calcitonin. Adequate urine output was maintained, and serum calcium dropped to 13 mg/dL within 24 hours and to 10.1 md/dL within 3 days.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The American Journal of Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Hypercalcemia: a review.JAMA. 2022; 328: 1624-1636
- Extreme hypercalcemia in a kidney transplant recipient.CEN Case Rep. 2018; 7: 229-233
- An unusual case of severe hypercalcemia: as dehydrated as a bone.J Community Hosp Intern Med Perspect. 2021; 11: 135-138
Published online: February 02, 2023
Accepted: January 20, 2023
Received: January 19, 2023
Publication stageIn Press Journal Pre-Proof
Conflict of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
© 2023 Elsevier Inc. All rights reserved.