PMID: 8580571Sep 1, 1995Paper

Development of hypercalcemic crisis in a Graves' hyperthyroid patient associated with central diabetes insipidus

Internal Medicine
A EndoH Mashiba

Abstract

A 26-year-old man with Graves' hyperthyroidism associated with central diabetes insipidus (DI), initially showed hypercalcemic crisis. Initially, very low serum levels of intact parathyroid hormone (PTH) and 1,25-dihydroxy vitamin D3 and a moderate rise of serum C-terminal PTH related protein (C-PTHrP) were observed which strongly suggested a humoral hypercalcemia of malignancy due to PTHrP. However, the serum C-PTHrP level later became normal. Mild hyperprolactinemia, no responses of growth hormone (GH) to insulin-induced hypoglycemia despite a normal growth hormone releasing hormone (GRH) test and mild thickening of the pituitary stalk on magnetic resonance imaging were observed. Thus, an autoimmune nature of his central DI is considered; it is noteworthy that the serum C-PTHrP level may be elevated by renal failure in patients with hypercalcemia due to causes other than PTHrP.

Citations

Jul 21, 2000·The Journal of Emergency Medicine·D VanpeeJ Donckier
Aug 26, 1999·Seminars in Oncology Nursing·M L Barnett
Jan 13, 2004·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Ayesha A IqbalCurtiss B Cook
Jan 20, 2021·BMJ Case Reports·Haris KhanHandrean Soran

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