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Case Reports in Endocrinology
Volume 2017, Article ID 3694868, 4 pages
https://doi.org/10.1155/2017/3694868
Case Report

Hypocalciuric Hypercalcemia due to Impaired Renal Tubular Calcium Excretion in a Type 2 Diabetic Patient

1Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
2Department of Chinese Traditional Medicine, The Second People’s Hospital of Yibin, Yibin, China

Correspondence should be addressed to Zhenmei An; moc.qq@343849848 and Tao Chen; moc.qq@oatnehc.rd

Received 17 November 2016; Accepted 9 January 2017; Published 11 April 2017

Academic Editor: Wayne V. Moore

Copyright © 2017 Sihao Yang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The case we presented here was a 73-year-old gentleman, who was admitted to endocrinology department due to recurrent fatigue for 1 year. He had medical histories of type 2 diabetes for 18 years and developed CKD 4 years ago. He also suffered from dilated cardiomyopathy, and coronary heart disease, moderate sleep apnea syndrome, primary hypothyroidism, and gout. His treatment regimen was complicated which included Caltrate D and compound α-keto acid (1200 mg calcium/d). Laboratory examination revealed that his serum calcium level elevated, 24-hour urine calcium output decreased, PTH level was suppressed, and 25-hydroxyvitamin D was in normal low range. No other specific abnormalities were found in serum bone turnover markers, ultrasonography, computed tomography, and bone scintigraphy. The diagnosis was suggested to be hypocalciuric hypercalcemia but was different from familial or acquired hypocalciuric hypercalcemia which were featured by elevated PTH level. The patient was asked to restrict calcium intake and to take diuretics; then his serum calcium level gradually lowered. In brief, patients with CKD could present with hypocalciuric hypercalcemia due to impaired renal calcium excretion. In this case, calcium restriction should be applied for treatment.