{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:02:45Z","timestamp":1740164565309,"version":"3.37.3"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:00:00Z","timestamp":1708041600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004909","name":"Universidade Federal do Rio Grande do Sul","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004909","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007380","name":"Funda\u00e7\u00e3o Instituto de Pesquisas Econ\u00f4micas","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007380","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003810","name":"Hospital de Cl\u00ednicas de Porto Alegre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003810","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Endocrinology"],"published-print":{"date-parts":[[2024,2,16]]},"abstract":"<jats:p>Introduction. The triad of hypercalcemia, metabolic alkalosis, and acute kidney injury associated with ingesting high doses of calcium and absorbable bases characterizes the calcium-alkali syndrome. Clinical Case. We report the case of a patient with postthyroidectomy hypoparathyroidism 15\u2009years ago due to differentiated thyroid cancer who presented with severe hypercalcemia. He had adequate control of calcemia for many years on treatment with calcitriol and calcium carbonate and hypertension treated with amlodipine, losartan, and hydrochlorothiazide. After a period of loss to follow-up, he suddenly presents with severe hypercalcemia, metabolic alkalosis, and loss of renal function. Upon hydration and withdrawal of calcitriol and calcium replacements, hypercalcemia resolved. The etiological investigation identified no granulomatous or neoplastic diseases, but an aldosterone-producing adrenal incidentaloma was found. The cause of hypercalcemia in this patient was calcium-alkali syndrome due to calcium carbonate replacement potentiated by hydrochlorothiazide and primary aldosteronism. Six months after the hospitalization and suspension of calcium and vitamin D, the patient returned to hypocalcemia, reinforcing the diagnosis. Conclusion. Although seldom described, the calcium-alkali syndrome is an expected complication for individuals with postoperative hypoparathyroidism, as they require lifelong calcium and vitamin D supplementation. This case also shows the importance of hydrochlorothiazide use and primary aldosteronism as possible triggers of life-threatening hypercalcemia.<\/jats:p>","DOI":"10.1155\/2024\/3067354","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T21:35:06Z","timestamp":1708119306000},"page":"1-6","source":"Crossref","is-referenced-by-count":1,"title":["Severe Hypercalcemia Caused by Calcium-Alkali Syndrome after 15\u2009Years of Postoperative Hypoparathyroidism in a Patient with Undiagnosed Hyperaldosteronism"],"prefix":"10.1155","volume":"2024","author":[{"given":"Nat\u00e1lia Diel","family":"Boufleuer","sequence":"first","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"},{"name":"Internal Medicine Division, Hospital de Cl\u00ednicas de Porto Alegre, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0819-5343","authenticated-orcid":true,"given":"Dimitris V.","family":"Rados","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"},{"name":"Internal Medicine Division, Hospital de Cl\u00ednicas de Porto Alegre, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"},{"name":"Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatiana","family":"Zambonato","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento, Porto Alegre, RS, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1728-8103","authenticated-orcid":true,"given":"Clara K.","family":"Maraschin","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2128-8387","authenticated-orcid":true,"given":"Beatriz D.","family":"Schaan","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"},{"name":"Internal Medicine Division, Hospital de Cl\u00ednicas de Porto Alegre, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"},{"name":"Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"},{"name":"Endocrine Division, Hospital de Cl\u00ednicas de Porto Alegre, Rua Ramiro Barcelos 2400, Zip Code 90035-903, Porto Alegre, RS, Brazil"},{"name":"National Institute of Science and Technology for Health Technology Assessment (IATS)-CNPq\/Brazil, Rua Ramiro Barcelos 2350, Zip Code 90035-903, Porto Alegre, RS, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"volume-title":"Cecil Medicina Interna","year":"2014","author":"L. 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