증상이 있는 고칼슘혈증을 동반한 갑상선기능항진증 환자에서 요중 데옥시피리디놀린의 변화
The Change of Urine Deoxypyridinoline in a Patient with Symptomatic Hypercalcemia associated with Hyperthyroidism
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Malignancy and primary hyperparathyroidism are the common causes of hypercalcemia. Although hyperthyroidism may induce mild asymptomatic hypercalcemia, it is very rare that hyperthyroidism causes symptomatic hypercalcemia with a serum calcium concentration ≥ 11 mg/dL. A 47-year-old woman visited our hospital for evaluation of nausea, vomiting, and urinary frequency. Her corrected total calcium level was 12.0 mg/dL. She was diagnosed with hyperthyroidism. We excluded the common causes of hypercalcemia by measurements of serum intact parathyroid hormone and a diagnostic work-up for malignancy. She was treated with propranolol and methimazole. The serum calcium and urine deoxypyridinoline, as a bone resorption marker, decreased and hypercalcemic symptoms resolved completely after restoration of the biochemical euthyroid state. In case of difficulty in excluding other causes of hypercalcemia in hyperthyroid patients, the follow-up of changes of bone turnover marker and level of serum calcium can be helpful.
Abstract
Malignancy and primary hyperparathyroidism are the common causes of hypercalcemia. Although hyperthyroidism may induce mild asymptomatic hypercalcemia, it is very rare that hyperthyroidism causes symptomatic hypercalcemia with a serum calcium concentration ≥ 11 mg/dL. A 47-year-old woman visited our hospital for evaluation of nausea, vomiting, and urinary frequency. Her corrected total calcium level was 12.0 mg/dL. She was diagnosed with hyperthyroidism. We excluded the common causes of hypercalcemia by measurements of serum intact parathyroid hormone and a diagnostic work-up for malignancy. She was treated with propranolol and methimazole. The serum calcium and urine deoxypyridinoline, as a bone resorption marker, decreased and hypercalcemic symptoms resolved completely after restoration of the biochemical euthyroid state. In case of difficulty in excluding other causes of hypercalcemia in hyperthyroid patients, the follow-up of changes of bone turnover marker and level of serum calcium can be helpful.
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