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Revista de Osteoporosis y Metabolismo Mineral
On-line version ISSN 2173-2345Print version ISSN 1889-836X
Abstract
CORDOBA, A et al. Hypercalcemia in patients with rheumatoid arthritis: a retrospective study. Rev Osteoporos Metab Miner [online]. 2021, vol.13, n.1, pp.5-9. Epub May 17, 2021. ISSN 2173-2345. https://dx.doi.org/10.4321/s1889-836x2021000100002.
Objetive
To investigate the prevalence of hypercalcemia in patients with rheumatoid arthritis (RA) and analyze the clinical features and causes of hypercalcemia.
Material and methods
Retrospective case-based review study that included 500 patients with RA. Patients with increased calcium levels on at least two occasions were identified.
Results
Hypercalcemia was present in 24 of the 500 RA patients (4.8%). The age ranged between 50 and 80 years, with a mean of 68±10 years. The mean duration of the disease was 10±7 years. Of the patients with hypercalcemia, 22 were postmenopausal women (92%) and only two were men (8%). Hyperparathyroidism was found in 9 patients in the series; only one patient had malignant hypercalcemia due to multiple myeloma, and one case was a consequence of vitamin D intoxication. In one patient, hypercalcemia appeared to be related to calcium-alkali syndrome. In the remaining patients, hypercalcemia was idiopathic (8/24) or the study was incomplete (4/24). No obvious relationship was found between disease activity and the appearance of hypercalcemia.
Conclusion
As in the general population, primary hyperparathyroidism is the most common cause of hypercalcemia in patients with RA. In some patients, no other disorders causing hypercalcemia were identified, raising the possibility of a causal relationship between RA and hypercalcemia.
Keywords : hypercalcemia; rheumatoid arthritis; hyperparathyroidism; vitamin D.