Abstract
Hypercalcemia most often results from primary hyperparathyroidism and malignancy. Adynamic bone disease (ABD) is a form of renal osteodystrophy characterized by reduced bone turnover, which can limit the ability of bone to release or store calcium, potentially leading to low, normal, or high serum calcium levels. We describe a 51‐year‐old dialysis‐dependent female with hypercalcemia after parathyroidectomy. A demeclocycline‐labeled bone biopsy confirmed adynamic bone disease. Teriparatide, a recombinant form of parathyroid hormone (PTH) used to treat postmenopausal osteoporosis, was prescribed for 12 months and normalized serum calcium levels. Although previous case reports and series have described favorable changes in spine bone mineral density when teriparatide was prescribed for ABD, ours is the first documented case in which teriparatide resolved hypercalcemia due to ABD. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
Highlights
Humans achieve calcium homeostasis through an intricate balance between multiple organ systems including the kidneys, bones, gastrointestinal tract, and parathyroid glands
Hypercalcemia most often results from either primary hyperparathyroidism or malignancy, any disease of these organs may lead to dysregulation of calcium balance and variations in serum calcium.[1]. Parathyroid hormone (PTH) tightly regulates serum calcium through multiple mechanisms: PTH increases renal 1,25(OH)2D synthesis to promote intestinal calcium absorption, enhances renal reabsorption of calcium in the distal tubules, and increases bone resorption to maintain normocalcemia
Adynamic bone disease (ABD) is a common form of Chronic kidney disease (CKD)-MBD among the dialysis population
Summary
Humans achieve calcium homeostasis through an intricate balance between multiple organ systems including the kidneys, bones, gastrointestinal tract, and parathyroid glands. Her serum calcium corrected for albumin was 10.6 mg/dL (normal, 8.5–10.2 mg/dL), phosphorus was 6.4 mg/ dL (2.5–4.5 mg/dL), PTH was
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