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<p>We report the rare case of a&#xa0;56-year-old woman with Graves’ disease who developed severe hypercalcemia and high bone turnover. The patient presented with weight loss, fatigue, nausea, and elevated liver enzymes, which at first pointed to a&#xa0;possible malignant or paraneoplastic condition. Blood tests confirmed thyrotoxicosis and positive TSH receptor antibodies, establishing the diagnosis of Graves’ disease. The patient’s calcium level was high, at 3.08 mmol/L, while parathyroid hormone was low, at 0.95 pmol/L, which ruled out primary hyperparathyroidism as a&#xa0;cause of hypercalcemia. As some tumor markers were slightly elevated and serum electrophoresis showed hypergammaglobulinemia, several causes of hypercalcemia were possible. Further investigations, including imaging studies, revealed no signs of a&#xa0;malignant disease. After treatment with thiamazole, β‑blocker, and fluid replacement, calcium, bone turnover markers, and thyroid hormones returned to normal, and clinical symptoms improved. Consequently, the hypercalcemia was explained by excessive thyroid function increasing bone turnover (high bone turnover) and, consecutively, also calcium levels.</p>

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„High bone turnover“ und Hyperkalzämie – Morbus Basedow als seltene nichtmaligne Ursache

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月9日

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  • Yunus Tünay,
  • Peter Mikosch

摘要

We report the rare case of a 56-year-old woman with Graves’ disease who developed severe hypercalcemia and high bone turnover. The patient presented with weight loss, fatigue, nausea, and elevated liver enzymes, which at first pointed to a possible malignant or paraneoplastic condition. Blood tests confirmed thyrotoxicosis and positive TSH receptor antibodies, establishing the diagnosis of Graves’ disease. The patient’s calcium level was high, at 3.08 mmol/L, while parathyroid hormone was low, at 0.95 pmol/L, which ruled out primary hyperparathyroidism as a cause of hypercalcemia. As some tumor markers were slightly elevated and serum electrophoresis showed hypergammaglobulinemia, several causes of hypercalcemia were possible. Further investigations, including imaging studies, revealed no signs of a malignant disease. After treatment with thiamazole, β‑blocker, and fluid replacement, calcium, bone turnover markers, and thyroid hormones returned to normal, and clinical symptoms improved. Consequently, the hypercalcemia was explained by excessive thyroid function increasing bone turnover (high bone turnover) and, consecutively, also calcium levels.