Secondary hyperparathyroidism and symptomatic hypercalcemia: overlooked complications of chronic liver disease
| Autor: | Hoilat Gj, Hoilat Jn, Emanuele Ma, Kadan S |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Cinacalcet Cirrhosis business.industry medicine.disease Chronic liver disease Gastroenterology Liver disease Calcitonin Internal medicine Medicine Secondary hyperparathyroidism Differential diagnosis business Hepatic encephalopathy hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | International Journal of Case Reports. :175 |
| ISSN: | 2572-8776 |
| DOI: | 10.28933/ijcr-2020-10-2605 |
| Popis: | A 71-year-old female with biopsy-proven liver cirrhosis was brought to the ER due to confusion for 5 days. She was diagnosed with acute decompensated liver disease and hepatic encephalopathy. Investigations also revealed PTH-dependent hypercalcemia. Both of these entities could be causing her symptoms. Neck ultrasound did not reveal any parathyroid lesions. Alteration in mental status persisted even after the management and resolution of hepatic encephalopathy. Symptomatic resolution occurred after normalization of her calcium levels which required normal saline, cinacalcet as well as calcitonin over the course of 7 days. Hypercalcemia secondary to chronic liver disease should be considered in the differential diagnosis of patients with liver cirrhosis presenting with an altered mental status. Hypercalcemia of chronic liver disease is not always transient and managed with normal saline as previously reported; It could necessitate more aggressive therapy with calcitonin and cinacalcet as reported in this case. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|