Case report: delayed hypercalcemia after rhabdomyolysis-induced acute renal failure

The American Journal of the Medical Sciences
L S Sperling, J A Tumlin

Abstract

Abnormal calcium metabolism is a common complication of rhabdomyolysis -induced acute renal failure. During the oliguric phase, patients are frequently hypocalcemic. Hyperphosphatemia and skeletal resistance to parathyroid hormone are believed to be possible underlying mechanisms. In addition, there have been reports of hypercalcemia during the diuretic recovery phase after rhabdomyolysis. The pathophysiology of the hypercalcemia observed in the recovery phase is a subject of debate. Several mechanisms have been proposed, including mobilization of calcium from muscle deposits, secondary hyperparathyroidism, and elevated levels of 1,25 dihydroxyvitamin D. The authors report the case of a 30-year-old man admitted for evaluation of marked hypercalcemia (18.3 mg/dL) who was hospitalized 3 weeks earlier for acute renal failure secondary to rhabdomyolysis. Plasma parathyroid hormone and 1,25 dihydroxyvitamin D levels were suppressed during the period of maximal hypercalcemia. A technetium pyrophosphate scan demonstrated extensive deposition of calcium throughout the pelvic and lower extremity muscles. This case of delayed hypercalcemia after rhabdomyolysis supports the hypothesis that mobilization of calcium deposits from soft tissue...Continue Reading

References

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Citations

May 9, 2002·The Journal of Small Animal Practice·J J Haburjak, W L Spangler
Sep 13, 2011·Annals of Intensive Care·Maryann ZhangKathleen D Liu
Sep 15, 2014·The American Journal of Case Reports·Lisa Aimee Hechanova, Seyed-Ali Sadjadi
Feb 12, 2011·Journal of the American Animal Hospital Association·Jill A WillamsonAlex Chisholm
Aug 15, 2003·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Violeta BoteaRajika L Munasinghe

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