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Lupus
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Systemic lupus erythematosus presenting as acute symptomatic hypercalcemia

J G Erdozain

Service of Internal Medicine, Hospital de Cruces, Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, Spain

M V Egurbide

Service of Internal Medicine, Hospital de Cruces, Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, Spain

G Ruiz-Irastorza

Service of Internal Medicine, Hospital de Cruces, Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, Spain, r.irastorza{at}euskalnet.net

J Ojanguren

Service of Haematology, Hospital de Galdakao Bizkaia, Spain

C Aguirre

Service of Internal Medicine, Hospital de Cruces, Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, Spain

Hypercalcemia is a common electrolyte abnormality with a wide differential diagnosis. Primary hyperparathyroidismand malignancy are the most frequent causes, accounting for more than 90% of cases. We report the case of a woman presenting with symptomatic severe hypercalcemia, who was subsequently diagnosed with systemic lupus erythematosus (SLE) due to the presence of arthritis, lymphopenia, antinuclear antibodies (ANA), anti-DNA and anti-Ro antibodies and low C3 levels. After acute treatment with intravenous fluids, steroids, diuretics and pamidronate, calcium levels corrected and have remained normal on low-dose prednisone.Five similar cases have been reported in the literature. Thus, SLE is an uncommon cause of hypercalcemia, which can also be the presenting feature of lupus.

Key Words: autoimmune diseases • calcium metabolism • systemic lupus erythematosus

Lupus, Vol. 13, No. 2, 132-134 (2004)
DOI: 10.1191/0961203304lu476cr
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