{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T19:49:38Z","timestamp":1783108178316,"version":"3.54.6"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Injection of paraffin oil to augment muscles size is a troubling phenomenon known to cause a foreign body reaction with formation of granulomas. In a few case reports, long-term side effects have been reported in terms of hypercalcemia and renal failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified a case series of 12 male bodybuilders presenting with non-parathyroid hypercalcemia who previously had injected paraffin oil to increase muscles size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At admission, all patients had moderate-to-severe hypercalcemia with suppressed PTH levels and impaired renal function. Calcitriol levels were within the normal range or slightly elevated. Follow-up measurements showed marked hypercalciuria with nearly normal levels of bone turnover markers. A correlation was found between levels of peptidyl dipeptidase and calcitriol (<jats:italic>R<\/jats:italic>\u2009=\u20090.812,<jats:italic>P<\/jats:italic>\u2009=\u20090.050). Treatment with antiresorptive agents seemed less effective than glucocorticoids, which resulted in a significantly lowering of ionized calcium levels and improved renal function, although no patients were cured by this treatment. Immunosuppression with azathioprine or mycophenolate may have a glucocorticoid-saving effect. One patient had surgery with removal of affected muscle tissue, without any apparent effect on plasma calcium levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The hypercalcemia and associated hypercalciuria seems to be due to an intestinal hyperabsorption of calcium. It remains to be elucidated, whether an increased calcitriol synthesis within granulomas is the only (main) mechanism by which intestinal calcium absorption is increased. Glucocorticoids seem most appropriate as the first choice for treatment. Bodybuilders should be warned against use of intramuscular oil injections (and other substances), as this may have severe adverse health consequences.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-18-0051","type":"journal-article","created":{"date-parts":[[2018,3,29]],"date-time":"2018-03-29T16:45:28Z","timestamp":1522341928000},"page":"K29-K37","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":23,"title":["Non-parathyroid hypercalcemia associated with paraffin oil injection in 12 younger male bodybuilders: a case series"],"prefix":"10.1093","volume":"178","author":[{"given":"Anne Sophie Koldkj\u00e6r","family":"S\u00f8lling","sequence":"first","affiliation":[{"name":"1Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte G","family":"Tougaard","sequence":"additional","affiliation":[{"name":"2Department of Nephrology and Internal Medicine, Regional Hospital Kolding, Kolding, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torben","family":"Harsl\u00f8f","sequence":"additional","affiliation":[{"name":"1Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bente","family":"Langdahl","sequence":"additional","affiliation":[{"name":"1Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle Kongsbak","family":"Brockstedt","sequence":"additional","affiliation":[{"name":"1Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keld-Erik","family":"Byg","sequence":"additional","affiliation":[{"name":"3Department of Rheumatology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Ivarsen","sequence":"additional","affiliation":[{"name":"4Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina Karstoft","family":"Ystr\u00f8m","sequence":"additional","affiliation":[{"name":"4Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank Holden","family":"Mose","sequence":"additional","affiliation":[{"name":"5University Clinic in Nephrology and Hypertension, Regional Hospital West Jutland and Aarhus University, Holstebro, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustaf Lissel","family":"Isaksson","sequence":"additional","affiliation":[{"name":"2Department of Nephrology and Internal Medicine, Regional Hospital Kolding, Kolding, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten Steen Svarer","family":"Hansen","sequence":"additional","affiliation":[{"name":"2Department of Nephrology and Internal Medicine, Regional Hospital Kolding, Kolding, Denmark"},{"name":"6Department of Endocrinology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subagini","family":"Nagarajah","sequence":"additional","affiliation":[{"name":"2Department of Nephrology and Internal Medicine, Regional Hospital Kolding, Kolding, Denmark"},{"name":"8Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Ejersted","sequence":"additional","affiliation":[{"name":"6Department of Endocrinology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Bendstrup","sequence":"additional","affiliation":[{"name":"7Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Rejnmark","sequence":"additional","affiliation":[{"name":"1Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"ref131","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.nefro.2015.09.005","article-title":"Lots of steroids and vitamins, tons of complications. 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