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Internal Medicine

Training Level

Resident PGY 3


Henry Ford Macomb


Hypercalcemia is commonly seen in patients with primary hyperparathyroidism and malignancy. Rarely, it can be seen in adrenal insufficiency. We report a case of a 42 year old female who presented with altered mental status and weakness. The patient had decreased appetite, nausea and significant weight loss of 60 pounds in the last few months. Laboratory evaluation was significant for hypercalcemia (15 mg/ dL) and acute kidney injury (1.5 mg/ dL). Work up for malignancy and hyperparathyroidism was negative. She was diagnosed with adrenal insufficiency based on cortisol levels prior to steroids of < 0.5 mcg/ dL. She was treated with steroids and her hypercalcemia resolved within two days of steroids. This case shows that adrenal insufficiency may present as hypercalcemia and acute kidney injury. It should be considered as a potential cause while evaluating a patient for hypercalcemia.

Presentation Date


Life threatening hypercalcemia: An unusual cause