Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Hypercalcemia Accompanied by Hypothalamic Hypopituitarism, Central Diabetes Inspidus and Hyperthyroidism
Seiki WADASusumu KURIHARAKeiji IMAMAKIKeisuke YOKOTAShinji KITAHAMAKayo YAMANAKAAkira ITABASHIMakoto IITAKAShigehiro KATAYAMA
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1999 Volume 38 Issue 6 Pages 486-490

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Abstract

We present here a case of prominent hypercalcemia accompanied by hypothalamic tumor and Graves' disease. A 24-year-old man with hypothalamic tumor showed hypopituitarism, central diabetes inspidus (DI) and hyperthyroidism. Nausea, loss of thirst and appetite, and general fatigue were found with the unveiling of hypercalcemia and hypernatremia. Parathyroid hormone (PTH) and lα-dihydroxyvitamin D levels were suppressed with a normal range of PTHrelated protein values. One-desamino-(8-D-arginine)-vasopressin (DDAVP) and half-saline administration normalized hypernatremia, while hypercalcemia was still sustained. Administration of cortisone acetate and thiamazole reduced the elevated serum Ca level. In the present case, concurrent hyperthyroidism was assumed to accelerate skeletal mobilization of calcium into the circulation. Hypocortisolism and central DI was also considered to contribute, to some extent, to the hypercalcemia through renal handling of Ca.
(Internal Medicine 38: 486-490, 1999)

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© The Japanese Society of Internal Medicine
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