Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation
Sodium-glucose cotransporter-2 (SGLT2) inhibitors have complex interactions with bone metabolism, including an increase in parathyroid hormone (PTH) levels. Here we report a case of a SGLT2 inhibitor-induced hypercalcemia due to primary hyperparathyroidism. In the subset of patients with normocalcem...
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SMC MEDIA SRL
2025-01-01
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| Series: | European Journal of Case Reports in Internal Medicine |
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| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/5169 |
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| author | Christodoulos Dolapsakis Emmanouil Karofylakis Stamatios Chalvatzis |
| author_facet | Christodoulos Dolapsakis Emmanouil Karofylakis Stamatios Chalvatzis |
| author_sort | Christodoulos Dolapsakis |
| collection | DOAJ |
| description | Sodium-glucose cotransporter-2 (SGLT2) inhibitors have complex interactions with bone metabolism, including an increase in parathyroid hormone (PTH) levels. Here we report a case of a SGLT2 inhibitor-induced hypercalcemia due to primary hyperparathyroidism. In the subset of patients with normocalcemic primary hyperparathyroidism, SGLT2 inhibitor initiation can unmask the disorder causing overt hypercalcaemic hyperparathyroidism. Although normocalcemic primary hyperparathyroidism is a rare entity, we propose obtaining a baseline PTH level before starting a SGLT2 inhibitor in patients with calcium levels in the upper limit of normal and normal total 25-hydroxyvitamin D levels, especially if they are under vitamin D supplementation. PTH should be rechecked in order to exclude overt primary hyperparathyroidism. |
| format | Article |
| id | doaj-art-ccf1864d591647e0aeb4ebc890c62e7d |
| institution | Kabale University |
| issn | 2284-2594 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj-art-ccf1864d591647e0aeb4ebc890c62e7d2025-02-04T13:37:20ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942025-01-0110.12890/2025_0051694704Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiationChristodoulos Dolapsakis0https://orcid.org/0000-0001-9251-7872Emmanouil Karofylakis1Stamatios Chalvatzis24th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, GreeceSodium-glucose cotransporter-2 (SGLT2) inhibitors have complex interactions with bone metabolism, including an increase in parathyroid hormone (PTH) levels. Here we report a case of a SGLT2 inhibitor-induced hypercalcemia due to primary hyperparathyroidism. In the subset of patients with normocalcemic primary hyperparathyroidism, SGLT2 inhibitor initiation can unmask the disorder causing overt hypercalcaemic hyperparathyroidism. Although normocalcemic primary hyperparathyroidism is a rare entity, we propose obtaining a baseline PTH level before starting a SGLT2 inhibitor in patients with calcium levels in the upper limit of normal and normal total 25-hydroxyvitamin D levels, especially if they are under vitamin D supplementation. PTH should be rechecked in order to exclude overt primary hyperparathyroidism.https://www.ejcrim.com/index.php/EJCRIM/article/view/5169sglt2 inhibitorshypercalcemiahyperparathyroidism |
| spellingShingle | Christodoulos Dolapsakis Emmanouil Karofylakis Stamatios Chalvatzis Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation European Journal of Case Reports in Internal Medicine sglt2 inhibitors hypercalcemia hyperparathyroidism |
| title | Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation |
| title_full | Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation |
| title_fullStr | Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation |
| title_full_unstemmed | Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation |
| title_short | Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation |
| title_sort | unmasking of normocalcemic primary hyperparathyroidism after sodium glucose cotransporter 2 inhibitor initiation |
| topic | sglt2 inhibitors hypercalcemia hyperparathyroidism |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/5169 |
| work_keys_str_mv | AT christodoulosdolapsakis unmaskingofnormocalcemicprimaryhyperparathyroidismaftersodiumglucosecotransporter2inhibitorinitiation AT emmanouilkarofylakis unmaskingofnormocalcemicprimaryhyperparathyroidismaftersodiumglucosecotransporter2inhibitorinitiation AT stamatioschalvatzis unmaskingofnormocalcemicprimaryhyperparathyroidismaftersodiumglucosecotransporter2inhibitorinitiation |