Extreme hypercalcaemia caused by immobilisation due to acute spinal cord injury

BMJ Case Rep. 2021 Jun 2;14(6):e241386. doi: 10.1136/bcr-2020-241386.

Abstract

Hypercalcaemia due to immobilisation is an uncommon diagnosis and requires extensive evaluation to rule out common causes of hypercalcaemia such as primary hyperparathyroidism and malignancy.We report an unusual case of profound hypercalcaemia due to immobilisation in a young man due to acute spinal cord ischaemia, leading to paraplegia. Other causes of hypercalcaemia were ruled out and elevated bone turnover markers supported our hypothesis. Conventional treatment with intravenous fluids, bisphosphonates and diuretics was insufficient. Subcutaneous calcitonin lowered the plasma calcium acutely and was continued for 8 weeks. Subsequent normocalcaemia was sustained for 2 years.

Keywords: calcium and bone; endocrinology.

Publication types

  • Case Reports

MeSH terms

  • Bone Density Conservation Agents* / therapeutic use
  • Calcitonin
  • Calcium
  • Diphosphonates / therapeutic use
  • Humans
  • Hypercalcemia* / diagnosis
  • Hypercalcemia* / etiology
  • Male
  • Spinal Cord Injuries* / complications

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Calcitonin
  • Calcium