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Hypercalcaemia as the initial presentation of Graves’ disease
  1. Kirandeep Kaur,
  2. Nisha Batra,
  3. Kavita Kadian and
  4. Kalyani Sridharan
  1. Endocrinology, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
  1. Correspondence to Dr Kalyani Sridharan; sridharan.kalyani22{at}


Hypercalcaemia in patients with hyperthyroidism is usually asymptomatic. It occurs due to increased bone turnover and demineralisation. There are only a few case reports where symptomatic hypercalcaemia was the presenting complaint of hyperthyroidism. An Asian man in his 40s presented to us with intractable vomiting for the last 6 months which was not controlled despite multiple antiemetic medications. On routine biochemistry performed at our institute, he was found to have hypercalcaemia and concomitant hyperthyroidism. Classical symptoms suggestive of hyperthyroidism were not present in our patient thus delaying the diagnosis. His symptoms resolved after the correction of hypercalcaemia. Hypercalcaemia did not recur after achieving an euthyroid status on treatment with carbimazole. Other common and more sinister causes for hypercalcaemia like malignancy were ruled out. This case highlights that symptomatic hypercalcaemia could be the initial presentation of hyperthyroidism and amelioration of hyperthyroidism corrects the hypercalcaemia.

  • Thyroid disease
  • General practice / family medicine

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  • Contributors KiK wrote the manuscript. KiK and NB were involved in patient care. KaK collected data and co-wrote the manuscript. KS critically revised the manuscript. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.