Hypercalcemia. A complication of advanced chronic liver disease

Hypercalcaemia associated with chronic viral hepatitis

“…In contrast, the usual causes of hypercalcaemia such as prolonged immobilization, hyperparathyroidism or pseudo-hyperparathyroidism, bone metastasis, vitamin D intake or aluminium hydroxide consumption were carefully excluded in the present report. The pattern ofhypercalcaemia presented in our case was similar to that of the patients in the series ofGerhardt et al 4 Moreover, calcium resorption observed here (Table I) led us to suggest that resorptive factors, i.e. OAF (osteoclast activating factor), TNF (tumour necrotizing factor), interleukin 1, prostaglandin or TGF (transforming growth factor)8'0 could be responsible for the hypercalcaemia presented by our patient.…”

“…3 However, in the absence of liver tumour, this metabolic complication has been rarely reported in the course of chronic liver disease. 4 Nevertheless, most patients in the series of Gerhardt et al4 were supplemented with vitamin D and thus the mechanism of hypercalcaemia was difficult to assess. In order to better understand this rare metabolic event, we have extensively evaluated a patient with a 2-year history of hypercalcaemia associated with hepatitis B virus (HBV) chronic hepatitis.…”

Rare Causes of Hypercalcemia

“…Advanced chronic liver disease was complicated by hypercalcemia in 10 patients without concomitant malignancy. Most had mild azotemia, and PTH levels were suppressed or in the low-normal range, as were levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D (65).…”

Liver Transplantation-associated Hypercalcemia Followed by Acute Renal Dysfunction

“…A small-for-size liver graft of 40% or less is a known factor for persistent hyperbilirubinemia after a living-related liver transplantation (5). Gerhardt et al reported that hypercalcemia is a possible complication in advanced chronic liver disease, even if it were not for the hepatoma, and that it often accompanies mild to moderate renal dysfunction suggested by an elevated serum creatinine level (6). To our knowledge, however, the hypercalcemia that emerged after posttransplant liver failure has not been described to date and should be examined with special care in the future.…”