This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Complication of Advanced Chronic Liver Disease

Ann Gerhardt, MD; Arthur Greenberg, MD; James J. Reilly, Jr, MD; David H. Van Thiel, MD

Arch Intern Med. 1987;147(2):274-277.

Abstract
• Hypercalcemia has not previously been recognized as a complication of advanced chronic liver disease without hepatoma. During a five-year period, 16 patients evaluated in the liver transplantation program at the University of Pittsburgh developed hypercalcemia. All had advanced chronic liver disease with mean total bilirubin concentration of 29.5 ±4.6 mg/dL (50.1 ±78.2 µmol/L (mean ± SEM) and prothrombin time 16.8 ± 0.8s. The highest serum calcium level was 17.2 mg/dL (4.3 mmol/L). The mean serum calcium level was 11.7±0.3 mg/dL (2.93±0.075 mmol/L) with an ionized calcium level of 5.41 ±0.35 mg/dL (1.35±0.088 mmol/L) and a phosphorus level of 4.2±0.4 mg/dL (1.4±0.1 nmol/L). Mild to moderate renal insufficiency was present in 14 (87%) patients; the mean serum creatinine level was 2.8±0.4 mg/dL (247 ±35 µmol/L). In five (38%) patients parathyroid hormone was completely suppressed and in an additional five (38%) patients, it was in a range most compatible with nonhyperparathyroid hypercalcemia. The 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D levels were normal or low in the 11 patients in whom determinations were made. Hypercalcemia that is not due to hyperparathyroidism or hypervitaminosis D is a potential complication of advanced chronic liver disease.

(Arch Intern Med 1987;147:274-277)

Author Affiliations
From the Division of Clinical Nutrition, Department of Internal Medicine, School of Medicine, University of California, Davis (Dr Gerhardt) and the Renal-Electrolyte (Dr Greenberg) and Gastroenterology Divisions (Dr Van Thiel) of the Department of Medicine and the Department of Surgery (Dr Reilly), University of Pittsburgh School of Medicine.

Footnotes
Accepted for publication April 7, 1986.

Reprint requests to Renal-Electrolyte Division, 1191 Scaife Hall, University of Pittsburgh, Pittsburgh, PA 15261 (Dr Greenberg).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Rare Causes of Hypercalcemia
Jacobs and Bilezikian
J. Clin. Endocrinol. Metab. 2005;90:6316-6322.
ABSTRACT | FULL TEXT  

Hypercalcemia
Palmieri and Pitcock
Arch Intern Med 1988;148:484-484.
ABSTRACT