A Case of Diabetes Mellitus and Hypercalcaemia
We report a case of diabetes mellitus in a middle-aged female who subsequently developed primary hyperparathyroidism and underwent parathyroidectomy. Prior to surgery, she was hospitalized several times since 1988 for vomiting, pain abdomen and dehydration. On none of these occasions hypercalcaemia could be documented. Yet she developed pancreatic calcification and diabetes in 1991 and was diagnosed as fibrocalculous pancreatic diabetes (FCPD) and treated with insulin. Nephrolithiasis developed in 2003. Hypercalcaemia with high PTH was detected in 2004 and a solitary right parathyroid adenoma was identified and surgically removed. Following surgery, gastrointestinal symptoms disappeared but diabetes remained unaltered on follow up for 8 years. The cause of multi-organ calcification which started well before development of hypercalcaemia is not known.
Bhansali A, Masoodi SR, Reddy KS et al. Primary hyperparathyroidism in North India: A description of 52 cases. Ann Saudi Med. 2005 ;25(1):29-35.
Mishra SK, Agarwal G, Kar DK, et al. Unique clinical characteristics of primary hyperparathyroidism in India. Br J Surg. 2001;88(5):708-14. http://dx.doi.org./10.1046/j.0007-1323.2001.01775.x
Broadus AE, Horst RL, Littledike ET et al. Primary hyperparathyroidism with intermittent hypercalcaemia: Serial observations and simple diagnosis by means of an oral calcium tolerance tests. Clin Endocrinol (Oxf). 1980;12(3):225-35. http://dx.doi.org/10.1111/j.1365-2265.1980.tb02704.x.
Barilla DE, Pak CY. Pitfalls in parathyroid evaluation in patients with calcium urolithiasis. Urol Res. 1979;7(3):177-82. http://dx.doi.org/10.1007/BF00257203.
Ljunghall S, Kallsen R, Backman U et al. Clinical effects of parathyroid surgery in normocalcaemic patients with recurrent renal stones. Acta Chir Scand. 1980;146(3):161-9.
Stone GR. Pancreas and parathyroid. Parathyroid adenoma in association with pancreatic calcification. J Kans Med Soc. 1962 Dec;63:519-21.
Kubota S, Yamada Y, Wakasugi H et al. An autopsy case of renal failure as its cause of death in a patient with primary hyperparathyroidism associated with chronic pancreatitis.Fukuoka Igaku Zasshi. 1996;87(10):226-8.
Taylor WH. The prevalence of diabetes mellitus in patients with hyperparathyroidism and among their relatives. Diabet Med 1991; 8(7): 683-687. http://dx.doi.org/ 10.1111/j.1464-5491.1991.tb01678.x.
Khaleeli AA, Johnson JN, Taylor WH. Prevalence of glucose intolerance in primary hyperparathyroidism and the benefit of parathyroidectomy. Diabetes Metab Res Rev. 2007;23(1):43-8. http://dx.doi.org/10.1002/dmrr.637.
Taylor WH, Khaleeli AA. Coincident diabetes mellitus and primary hyperparathyroidism. Diabetes Metab Res Rev. 2001 ;17(3):175-80. http://dx.doi.org/10.1002/dmrr.199.
Ljunghall S, Palmer M, Akerstrom G et al. Diabetes mellitus, glucose tolerance and insulin response to glucose in patients with primary hyperparathyroidism before and after parathyroidectomy. Eur J Clin Invest. 1983 ;13(5):373-7. http://dx.doi.org/ 10.1111/j.1365-2362.1983.tb00116.x.
Balaji LN, Tandon RK, Tandon BN, et al. Prevalence and clinical features of chronic pancreatitis in southern India. Int J Pancreatol. 1994 ;15(1):29-34.
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