Case Report
Volume: 5 | Issue: 6 | Published: Jun 23, 2021 | Pages: 187 - 190 | DOI: 10.24911/ejmcr/173-1614468533
A case of chronic asymptomatic hypercalcemia in an individual with insulin resistance syndrome
Authors: Neil Roy , Sylvia Rosas
Article Info
Authors
Neil Roy
Kidney and Hypertension Unit, Joslin Diabetes Center, Harvard Medical School, Boston, MA
Sylvia Rosas
Kidney and Hypertension Unit, Joslin Diabetes Center, Harvard Medical School, Boston, MA
Publication History
Received: March 01, 2021
Revised: May 10, 2021
Accepted: May 25, 2021
Published: June 23, 2021
Abstract
Background: Calcium, the major inorganic component in bone, plays an important role in insulin secretion and insulin resistance. Insulin resistance is essential in the pathophysiology of non-alcoholic steatohepatitis (NASH), polycystic ovarian syndrome (PCOS), and Type 2 diabetes mellitus (DM). Case Presentation: We present a case of chronic asymptomatic hypercalcemia in an individual with NASH, PCOS, and DM. She was noted to have a serum calcium of 12.8 mg/dl and a homeostatic model assessment of insulin resistance (HOMA-IR) of 4.7 in the last 2 years. Almost all other causes of hypercalcemia were ruled out. The patient was treated conservatively and advised to avoid factors that can aggravate hypercalcemia. Conclusion: The insulin effect on calcium homeostasis is impaired in conditions of insulin resistance. There is increasing evidence of the association between hypercalcemia and insulin resistance. However, it remains a diagnosis of exclusion.
Keywords: Liver disease, hypercalcemia, non-alcoholic steatohepatitis, insulin resistance, diabetes mellitus, green
