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Anna Eremkina Endocrinology Research Center, Russian Federation, Moscow, Russia

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Julia Krupinova Endocrinology Research Center, Russian Federation, Moscow, Russia

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Ekaterina Dobreva Endocrinology Research Center, Russian Federation, Moscow, Russia

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Anna Gorbacheva Endocrinology Research Center, Russian Federation, Moscow, Russia

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Ekaterina Bibik Endocrinology Research Center, Russian Federation, Moscow, Russia

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Margarita Samsonova Faculty of Fundamental Medicine, ederal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University, Moscow, Russia

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Alina Ajnetdinova Endocrinology Research Center, Russian Federation, Moscow, Russia

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Natalya Mokrysheva Endocrinology Research Center, Russian Federation, Moscow, Russia

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Introduction Primary hyperparathyroidism (PHPT) and malignancy are the two most common causes of hypercalcemia ( 1 ). Hypercalcemic crisis (HC) is an uncommon, but severe complication of PHPT more specifically for parathyroid cancer ( 2 ). The

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Sondra O’Callaghan Endocrinology, Diabetes & Metabolism, Orlando VA Healthcare System, Orlando, Florida, USA

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Hanford Yau Endocrinology, Diabetes & Metabolism, Orlando VA Healthcare System, Orlando, Florida, USA

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Introduction Malignancy-associated hypercalcemia (MAH) has long been described in medical literature and has posed a therapeutic conundrum. Over decades, this form of hypercalcemia has eluded conventional therapies, in that, it responds only

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Gabriella Oliveira Lima Laboratory of Pharmacology and Toxicology of Natural Products, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Alex Luiz Menezes da Silva Laboratory of Pharmacology and Toxicology of Natural Products, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Julianne Elba Cunha Azevedo Laboratory of Pharmacology and Toxicology of Natural Products, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Chirlene Pinheiro Nascimento Laboratory of Pharmacology and Toxicology of Natural Products, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Luana Rodrigues Vieira Laboratory of Pharmacology and Toxicology of Natural Products, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Akira Otake Hamoy Laboratory of Pharmacology and Toxicology of Natural Products, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Luan Oliveira Ferreira Laboratory of Experimental Neuropathology, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Verônica Regina Lobato Oliveira Bahia Multidisciplinary Laboratory of Animal Morphology, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Nilton Akio Muto Amazon Bioactive Compounds Valorization Center, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Dielly Catrina Favacho Lopes Laboratory of Experimental Neuropathology, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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Moisés Hamoy Laboratory of Pharmacology and Toxicology of Natural Products, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil

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result in a set of consequences related to hypervitaminosis D, with symptoms that may be related hypercalcemia, which, although rare, has been reported more frequently in recent years ( 8 , 12 , 13 , 14 ). The symptoms of vitamin D toxicity (VDT) can

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Cheng Han Ng Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Yip Han Chin Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Marcus Hon Qin Tan Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Jun Xuan Ng Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Samantha Peiling Yang Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Department of Medicine, National University Hospital, Singapore

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Jolene Jiayu Kiew Department of Medicine, National University Hospital, Singapore

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Chin Meng Khoo Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Department of Medicine, National University Hospital, Singapore

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) syndrome. Patients with PHPT might present with cardinal signs of hypercalcemia with significant involvement from both renal and skeletal system presenting with recurrent nephrolithiasis, fragility fractures, or both ( 2 ). Parathyroidectomy is the

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Liubov G Yanevskaya Almazov National Medical Research Centre, St. Petersburg, Russia

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Tatiana Karonova Almazov National Medical Research Centre, St. Petersburg, Russia
First Pavlov State Medical University, St. Petersburg, Russia

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Ilya V Sleptsov Saint-Petersburg State University N.I. Pirogov Clinic of High Medical Technologies, St. Petersburg, Russia

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Marina Evgenevna Boriskova First Pavlov State Medical University, St. Petersburg, Russia

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Aluza Ramilevna Bakhtiyarova Almazov National Medical Research Centre, St. Petersburg, Russia

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Roman A Chernikov Saint-Petersburg State University N.I. Pirogov Clinic of High Medical Technologies, St. Petersburg, Russia

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Karina Aleksandrovna Pogosian Almazov National Medical Research Centre, St. Petersburg, Russia

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Alena Timurovna Andreeva Almazov National Medical Research Centre, St. Petersburg, Russia

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Denis Andreevich Lebedev Almazov National Medical Research Centre, St. Petersburg, Russia

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Elena Nikolaevna Grineva Almazov National Medical Research Centre, St. Petersburg, Russia
First Pavlov State Medical University, St. Petersburg, Russia

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John P Bilezikian College of Physicians and Surgeons, Columbia University, New York, New York, USA

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Introduction Primary hyperparathyroidism (PHPT) is a disease characterized by excessive synthesis and secretion of parathyroid hormone (PTH) from one or more of the four parathyroid glands ( 1 ). Most patients present with hypercalcemia though

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Mengting Yin Sichuan University West China Hospital, Chengdu, China

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Qianhui Liu Sichuan University West China Hospital, Chengdu, China

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Qingzhong Wang Jintang First People’s Hospital, West China Hospital Sichuan University Jingtang Hospital, Chengdu, China

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Yong He Sichuan University West China Hospital, Chengdu, China

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Haolan Song Sichuan University West China Hospital, Chengdu, China

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Xin Nie Sichuan University West China Hospital, Chengdu, China

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Guixing Li Sichuan University West China Hospital, Chengdu, China

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single parathyroid adenoma and less than 1% by parathyroid adenocarcinoma ( 2 ). Traditionally, patients with PHPT typically have hypercalcemia and elevated parathyroid hormone (PTH) levels ( 3 , 4 ). Dysregulation of PTH, the most important metabolic

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Katherine Van Loon
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Li Zhang
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Jennifer Keiser
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Cendy Carrasco
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Katherine Glass The UCSF Helen Diller Family Comprehensive Cancer Center, The Ohio State University Comprehensive Cancer Center, National Comprehensive Cancer Network, University of California, San Francisco, 1600 Divisadero Street, UCSF Box 1770, San Francisco, California 94143, USA

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Maria-Teresa Ramirez The UCSF Helen Diller Family Comprehensive Cancer Center, The Ohio State University Comprehensive Cancer Center, National Comprehensive Cancer Network, University of California, San Francisco, 1600 Divisadero Street, UCSF Box 1770, San Francisco, California 94143, USA

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Sarah Bobiak The UCSF Helen Diller Family Comprehensive Cancer Center, The Ohio State University Comprehensive Cancer Center, National Comprehensive Cancer Network, University of California, San Francisco, 1600 Divisadero Street, UCSF Box 1770, San Francisco, California 94143, USA

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Eric K Nakakura
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Alan P Venook
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Manisha H Shah The UCSF Helen Diller Family Comprehensive Cancer Center, The Ohio State University Comprehensive Cancer Center, National Comprehensive Cancer Network, University of California, San Francisco, 1600 Divisadero Street, UCSF Box 1770, San Francisco, California 94143, USA

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Emily K Bergsland
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) such as bone pain, spinal cord compression, pathological fracture, and/or hypercalcemia. Thus, prompt diagnosis and intervention hold the promise of reducing the associated morbidity and sequelae of bone metastases. This is particularly relevant in a

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Julia Herteux Medical University of Graz, Auenbruggerplatz, Graz, Austria

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Simon Johannes Geiger Medical University of Graz, Auenbruggerplatz, Graz, Austria

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Christina Starchl Medical University of Graz, Auenbruggerplatz, Graz, Austria

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Johanna Windisch Medical University of Graz, Auenbruggerplatz, Graz, Austria

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Theresa Lerchl Medical University of Graz, Auenbruggerplatz, Graz, Austria

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Adelina Tmava-Berisha Medical University of Graz, Auenbruggerplatz, Graz, Austria

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Gerit Wünsch Medical University of Graz, Auenbruggerplatz, Graz, Austria

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Kathrin Eller Medical University of Graz, Auenbruggerplatz, Graz, Austria

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Astrid Fahrleitner-Pammer Medical University of Graz, Auenbruggerplatz, Graz, Austria

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Karin Amrein Medical University of Graz, Auenbruggerplatz, Graz, Austria

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patients over a period of 17 years. In total, we recorded 219 ER visits, 627 hospitalizations and 12 deaths. Surprisingly, patients requiring immediate treatment of hypo-/hypercalcemia-related symptoms were the minority for presentation in the hospital

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Jennifer Walsh The Mellanby Centre for Bone Research, The Medical School, The University of Sheffield, Sheffield, UK

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Neil Gittoes Centre for Endocrinology, Diabetes and Metabolism, University Hospitals Birmingham & University of Birmingham, Birmingham Health Partners, Birmingham, UK

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Peter Selby Department of Medicine, Manchester Royal Infirmary, Manchester, UK

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the Society for Endocrinology Clinical Committee The Society for Endocrinology, 22 Apex Court, Woodlands, Bradley Stoke, Bristol, UK

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. Sources 1 LeGrand SB Leskuski D Zama I. Narrative review: furosemide for hypercalcemia: an unproven yet common practice . Annals of Internal Medicine 2008 149 259 – 263 . ( doi:10.7326/0003-4819-149-4-200808190-00007 ) 2 Nussbaum

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Tomás P Griffin Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland
Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland

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Caroline M Joyce Department of Clinical Biochemistry, Cork University Hospital, Cork, Ireland

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Sumaya Alkanderi Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK

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Liam M Blake Department of Clinical Biochemistry, SUHCG, GUH, Galway, Ireland

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Derek T O’Keeffe Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland

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Delia Bogdanet Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland

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Md Nahidul Islam Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland
Department of Clinical Biochemistry, SUHCG, GUH, Galway, Ireland

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Michael C Dennedy Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland
Lambe Institute for Translational Research, School of Medicine, NUIG, Galway, Ireland

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John E Gillan Department of Histopathology, SUHCG, GUH, Galway, Ireland

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John J Morrison Department of Obstetrics and Gynaecology, SUHCG, GUH, Galway, Ireland

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Timothy O’Brien Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland
Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland

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John A Sayer Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle upon Tyne, UK
NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK

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Marcia Bell Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland

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Paula M O’Shea Department of Clinical Biochemistry, SUHCG, GUH, Galway, Ireland

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trimester. The proband’s father (I.1) was homozygous for the R439C pathogenic mutation but did not have hypercalcaemia, which may be due to the variable penetrance of this mutation together with external factors that mitigate the development of hypercalcemia

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