Symptomatic Hypercalcemia Due to Painless Thyroiditis after Unilateral Adrenalectomy in a Patient with Cushing's Syndrome

Hironari Kimura; Kanji Sato; Momoko Nishimaki; Nobuhiro Miki; Masami Ono; Kazue Takano

doi:10.2169/internalmedicine.47.0616

CASE REPORTS

Symptomatic Hypercalcemia Due to Painless Thyroiditis after Unilateral Adrenalectomy in a Patient with Cushing's Syndrome

Hironari Kimura, Kanji Sato, Momoko Nishimaki, Nobuhiro Miki, Masami Ono, Kazue Takano

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Keywords: hypercalcemia, Addison's disease, Cushing's syndrome, painless thyroiditis, thyrotoxicosis, hypoadrenalism

JOURNAL OPEN ACCESS

2008 Volume 47 Issue 8 Pages 751-756

DOI https://doi.org/10.2169/internalmedicine.47.0616

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Abstract

We report a 53-year-old woman with Cushing's syndrome due to an adrenocortical adenoma, who underwent unilateral adrenalectomy and developed symptomatic hypercalcemia during the thyrotoxic period of painless thyroiditis, while tapering off a daily supplemented dose of cortisol. A study of patients with thyrotoxicosis and hypoadrenalism at our institute revealed that mild hypercalcemia was present in 9.9% of those with thyrotoxicosis and 5.0% of those with hypoadrenalism. The present case suggests that the simultaneous occurrence of thyrotoxicosis and hypoadrenalism may lead to overt hypercalcemia due to a synergistic increase in bone resorption and impaired urinary excretion of calcium.

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