{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:56:07Z","timestamp":1789055767246,"version":"build-2803163510"},"reference-count":17,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:00:00Z","timestamp":1622592000000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,5]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>Hypercalcaemia due to immobilisation is an uncommon diagnosis and requires extensive evaluation to rule out common causes of hypercalcaemia such as primary hyperparathyroidism and malignancy.<\/jats:p>\n               <jats:p>We report an unusual case of profound hypercalcaemia due to immobilisation in a young man due to acute spinal cord ischaemia, leading to paraplegia. Other causes of hypercalcaemia were ruled out and elevated bone turnover markers supported our hypothesis. Conventional treatment with intravenous fluids, bisphosphonates and diuretics was insufficient. Subcutaneous calcitonin lowered the plasma calcium acutely and was continued for 8 weeks. Subsequent normocalcaemia was sustained for 2 years.<\/jats:p>","DOI":"10.1136\/bcr-2020-241386","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:13:35Z","timestamp":1622679215000},"page":"e241386","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Extreme hypercalcaemia caused by immobilisation due to acute spinal cord injury"],"prefix":"10.1136","volume":"14","author":[{"given":"Jesse Marc","family":"Tettero","sequence":"first","affiliation":[{"name":"Hematology, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmer","family":"van Eeghen","sequence":"additional","affiliation":[{"name":"Internal Medicine, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albertus Jozef","family":"Kooter","sequence":"additional","affiliation":[{"name":"Internal Medicine, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,6,2]]},"reference":[{"key":"2025082703485332000_14.6.e241386.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-92-3-343"},{"key":"2025082703485332000_14.6.e241386.2","first-page":"41","article-title":"Immobilization hypercalcemia following spinal cord injury","volume":"67","author":"Maynard","year":"1986","journal-title":"Arch Phys Med Rehabil"},{"key":"2025082703485332000_14.6.e241386.3","first-page":"316","article-title":"Successful treatment of immobilization hypercalcemia using calcitonin and etidronate","volume":"74","author":"Meythaler","year":"1993","journal-title":"Arch Phys Med Rehabil"},{"key":"2025082703485332000_14.6.e241386.4","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-1-9-711"},{"key":"2025082703485332000_14.6.e241386.5","first-page":"46","article-title":"Immobilization induced hypercalcemia","volume":"13","author":"Cano-Torres","year":"2016","journal-title":"Clin Cases Miner Bone Metab"},{"key":"2025082703485332000_14.6.e241386.6","article-title":"Hypercalcemia in children with spinal cord injury","volume":"59","author":"Tori","year":"1978","journal-title":"Arch Phys Med Rehabil"},{"key":"2025082703485332000_14.6.e241386.7","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1948"},{"key":"2025082703485332000_14.6.e241386.8","first-page":"263","article-title":"Sclerostin: a novel target for intervention in the treatment of osteoporosis","volume":"12","author":"Lewiecki","year":"2011","journal-title":"Discov Med"},{"key":"2025082703485332000_14.6.e241386.9","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1002\/jbmr.2396","article-title":"Sclerostin inhibition prevents spinal cord injury-induced cancellous bone loss","volume":"30","author":"Beggs","year":"2015","journal-title":"J Bone Miner Res"},{"key":"2025082703485332000_14.6.e241386.10","article-title":"Spinal cord injury and osteoporosis: causes, mechanisms, and rehabilitation strategies","volume":"1","author":"Tan","year":"2013","journal-title":"Int J Phys Med Rehabil"},{"key":"2025082703485332000_14.6.e241386.11","doi-asserted-by":"crossref","first-page":"7238","DOI":"10.1002\/jcb.27998","article-title":"Selective \u03b22\u2010adrenoreceptor signaling regulates osteoclastogenesis via modulating RANKL production and neuropeptides expression in osteocytic MLO\u2010Y4 cells","volume":"120","author":"Liang","year":"2019","journal-title":"J Cell Biochem"},{"key":"2025082703485332000_14.6.e241386.12","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-198904000-00012"},{"key":"2025082703485332000_14.6.e241386.13","first-page":"640","article-title":"Calcitonin therapy in prolonged immobilization hypercalcemia","volume":"66","author":"Carey","year":"1985","journal-title":"Arch Phys Med Rehabil"},{"key":"2025082703485332000_14.6.e241386.14","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1152\/physrev.00066.2017","article-title":"The activity of peptides of the calcitonin family in bone","volume":"99","author":"Naot","year":"2019","journal-title":"Physiol Rev"},{"key":"2025082703485332000_14.6.e241386.15","unstructured":"European Medicines Agency . Assessment report for calcitonin containing medicinal products. Referral Assessment Report Procedure number: EMEA\/H\/A-31\/1291, 2012."},{"key":"2025082703485332000_14.6.e241386.16","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfs133"},{"key":"2025082703485332000_14.6.e241386.17","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s13730-017-0254-5","article-title":"Denosumab for treatment of immobilization-related hypercalcemia in a patient with end-stage renal disease","volume":"6","author":"Uehara","year":"2017","journal-title":"CEN Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-241386","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:49:07Z","timestamp":1756291747000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-241386"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":17,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,2]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bcr-2020-241386"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-241386","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}