Document Type
Article
Publication Date
6-6-2023
Abstract
BACKGROUND: Idiopathic Calcitriol Induced Hypercalcemia is a rare cause of a common condition of hypercalcemia. Hypercalcemia is most commonly the result of hyperparathyroidism and together with hypercalcemia of malignancy accounts for over 95% of cases. Idiopathic Calcitriol Induced Hypercalcemia can mimic hypercalcemia secondary to granulomatous diseases like sarcoidosis, but with apparent absences of both imaging and physical exam findings consistent with the disease. We report here a 51-year-old man who presented with recurrent nephrolithiasis, hypercalcemia, and acute kidney injury.
CASE PRESENTATION: A 51-year-old man presented with severe back pain and mild hematuria. He had a history of recurrent nephrolithiasis over the course of a 15-year period. On presentation his calcium was elevated at 13.4 mg/dL, creatinine was 3.1 mg/dL (from baseline of 1.2), and his PTH was reduced at 5 pg/mL. CT abdomen and pelvis showed acute nephrolithiasis which was managed medically. Work up for the hypercalcemia included an SPEP which was normal, Vit D,1,25 (OH)2 was elevated at 80.4 pg/mL, CT chest showed no evidence of sarcoidosis. Management with 10 mg prednisone showed marked improvement in the hypercalcemia and he no longer had any symptoms of hypercalcemia.
CONCLUSION: Idiopathic Calcitriol Induced Hypercalcemia is a rare cause of hypercalcemia. All reported cases benefit from more intensive long-term immunosuppression. This report helps consolidate the diagnosis of Idiopathic Calcitriol Induced Hypercalcemia and encourages researchers to better investigate its underlying pathogenesis.
Recommended Citation
Fadel, Omar El; Kenkare, Anshel; and Zhang, Jingjing, "Steroid Responsive Idiopathic Calcitriol Induced Hypercalcemia: A Case Report and Review of the Literature" (2023). Division of Internal Medicine Faculty Papers & Presentations. Paper 65.
https://jdc.jefferson.edu/internalfp/65
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
37280532
Language
English
Comments
This article is the author's final published version in BMC Nephrology, Volume 24, Issue 1, June 2023, Article number 159.
The published version is available at https://doi.org/10.1186/s12882-023-03203-4.
Copyright © The Author(s) 2023.
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