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Hypercalcaemia associated with chronic viral hepatitis C

Abstract number: 1733_719

Yesilkaya A., Memikoglu K.O., Azap A., Demir Ö., Balik I.

Introduction: Hypercalcaemia has been reported in the course of some cases of cirrhosis complicated by hepatocellular carcinoma or cholangiocarcinoma and in patients with hepatic tumours in the absence ofcirrhosis. However in the absence of liver tumour, this metabolic complication has been rarely reported in the course of chronic liver disease. We described here hypercalcaemia associated with chronic hepatitis C.

Case report: A 71 year old man was admitted in Febuary 2006 for exploration of back pain. He had had HCV chronic hepatitis for 15 years. Tests showed hypercalcaemia, bicytopenia and mild increase in aminotransferases. Serum calcium, ionised calcium were elevated and serum phosphorus, 24-hour urinary calcium excretion were normal. The level of serum immunoreactive parathyroid hormone (PTH) was normal. Nephrogenic cAMP 2.38 mmol/L, PTH-related peptide <0.2 pmol/L and a-fetoprotein were normal whereas plasma 1,25 (OH)2 vitamin D3 (25 pg/mL) was slightly high. There were none of the major causes of true hypercalcaemia such as any malignancy, hyperthyroidism, hyperparathyroidism and chronic bone disaese. Serum protein electrophoresis showed an increase in ammaglobulins with no monoclonol paraprotein lectrophoresis, total body 99-techntium radionuclide scan showed no increased uptake; chest X-ray and kidney ultrasonography were normal. There was no history of excessive aluminium derivates, milk or alkali intake, thiazide diuretic or vitamin A and D supplementation.

Discussion: Hypercalcaemia has been reported by Gerhardt et al. in eleven patients waiting for liver transplantation with chronic liver disease without hepatic tumour. Resorptive factors like interleukin-1, transforming growth factor, tumour necrotising factor, osteoclast activating factor, or prostaglandin could be responsible for the hypercalcaemia.

Conclusion: Hypercalcaemia could be a rare metabolic feature of chronic viral hepatitis C; the underlying mechanisms remain to be elucidated.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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