Health Care : Current Reviews

Parathyroid Hormone (PTH) independent hypercalcemia

Joint Webinar: 14^th International Conference on Clinical Case Reports & 6^th International Conference on Pediatrics and Healthcare & 10^th World Summit on Oncology and Cancer Science

November 24, 2022 | Webinar

Wint Wah Oo* and Kaung Kyaw Mina

Southend University Hospital, United Kingdom

Keynote: Health Care Curr Rev

Abstract:

Hypercalcaemia is a common clinical presentation, primarily associated with Hyperparathyroidism and malignancy. However, other causes such as Sarcoidosis should not be neglected as differential diagnosis for hypercalcaemia. As welldocumented, Sarcoidosis is an unusual granulomatous disease affecting multiple rgans including lungs, lymph node, skin and central nervous system. Here, we are reporting a case of 64-year-old gentleman, presented with shortness of breath, cough, weight loss, chronic constipation and abdominal pain. He has background of hypertensive nephropathy on haemodialysis and total parathyroidectomy for Tertiary hyperparathyroidism. Blood test showed Hypercalcaemia at 3.13mmol/L (2.2-2.6 mmol/L) with low PTH at 0.3 pmol/L (1.6-6.9 pmol/L), elevated 1,25-Dihydroxycholecalciferol of 72 pg/L (18-64 pg/L) and high serum ACE of 96 U/l (16-85 U/l). Meanwhile, other blood results including PTH-related peptide (PTHrP), screening for Myeloma and Thyroid function test were unremarkable. In addition, Sputum AFB smear and TB-PCR tests were also negative. However, chest X-ray showed bilateral mediastinal lymphadenopathy. On account of hypercalcaemia, mediastinal lymphadenopathy and unintentional weight loss, whole-body CT scan was performed, and it showed enlarged lymph nodes in paratracheal, subcarinal, pre-tracheal and bilateral pulmonary hila region and peri-broncho-vascular nodularity in both lungs. Subsequently, through Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS TBNA), the patient was diagnosed with non-caseating granuloma, Sarcoidosis. Consequently, he was treated with oral Prednisolone and Hypercalcemia was found to be normalised in the following clinic visits. To conclude, there are many more case reports on Sarcoidosis, presenting with hypercalcaemia owing to increased 1-alphahydroxylase activity in granulomas which leading to increased 1,25-Dihydroxyvitamin D. Therefore, Sarcoidosis should be considered as one of differential diagnosis, especially for patients presenting with unexplained Hypercalcaemia.

Biography :

Wint Wah Oo completed her graduation (MBBS) from Membership of the Royal College of Physicians, United Kingdom. She is a Specialty in General Medicine. Wint Wah Oo has special interest in General Medicine, Internal Medicine, Respiratory Medicine. She has published her research papers in reputed journals.