{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T07:05:49Z","timestamp":1764745549361,"version":"3.46.0"},"reference-count":0,"publisher":"Touch Medical Media, Ltd.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015]]},"abstract":"<jats:p>The association of chronic tophaceous gout with severe hypercalcaemia is exceptional. In this case, a 42-year old man with a longstanding history of gout arrived at the emergency room with altered mental status. Laboratory work up revealed a uric acid of 14.0 mg\/dl, corrected calcium of 14.5 mg\/dl, phosphorous of 6.3 mg\/dl, parathyroid hormone (PTH) was suppressed (&lt;3.0 pg\/ml), 25-dihydroxyvitamin D 25.2 ng\/ml, parathyroid hormone related-protein (PTHrP) was 45.0 pg\/ml and calcitriol 19.6 pg\/ml. Biopsy histopathology result showed deposits of monosodium urate crystals surrounded by granulomatous inflammation. The association of chronic tophaceous gout with severe hypercalcaemia is extremely rare and has been usually described to be secondary to 1-25 dihydroxyvitamin D (calcitriol) secretion. In this case, calcitriol levels were normal and this possibility was excluded. On the other hand, PTHrP had never been, until now, described as the responsible cause of hypercalcaemia in gout. In our case, baseline PTHrP and calcium values were elevated and after medical treatment both returned to normal values. PTHrP usually causes hypophosphataemia and in this case the abnormal renal function could have diminished this last effect.<\/jats:p>","DOI":"10.17925\/ee.2015.11.02.102","type":"journal-article","created":{"date-parts":[[2015,8,31]],"date-time":"2015-08-31T05:39:20Z","timestamp":1440999560000},"page":"102","source":"Crossref","is-referenced-by-count":1,"title":["Severe Hypercalcaemia \u2013 Chronic Tophaceous Gout as the Responsible Cause?"],"prefix":"10.17925","volume":"11","author":[{"given":"Ren\u00e9","family":"Rodr\u00edguez-Guti\u00e9rrez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Azucena","family":"Zapata-Rivera","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla Victoria","family":"Rodriguez-Velver","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando J","family":"Lavalle-Gonzalez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Gerardo","family":"Gonzalez-Gonzalez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesus Zacarias","family":"Villarreal-Perez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Endocrinology Division, Department of Internal Medicine, University Hospital \u2018Dr Jos\u00e9 E Gonz\u00e1lez\u2019, Universidad Autonoma de Nuevo Le\u00f3n, Monterrey, M\u00e9xico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota, US","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Endocrinology Division, Department of Internal Medicine, University Hospital \u2018Dr Jos\u00e9 E Gonz\u00e1lez\u2019, Universidad Autonoma de Nuevo Le\u00f3n, Monterrey, M\u00e9xico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Endocrinology Division, Department of Internal Medicine, University Hospital \u2018Dr Jos\u00e9 E Gonz\u00e1lez\u2019, Universidad Autonoma de Nuevo Le\u00f3n, Monterrey, M\u00e9xico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Endocrinology Division, Department of Internal Medicine, University Hospital \u2018Dr Jos\u00e9 E Gonz\u00e1lez\u2019, Universidad Autonoma de Nuevo Le\u00f3n, Monterrey, M\u00e9xico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Endocrinology Division, Department of Internal Medicine, University Hospital \u2018Dr Jos\u00e9 E Gonz\u00e1lez\u0092, Universidad Autonoma de Nuevo Le\u00f3n, Monterrey, M\u00e9xico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Endocrinology Division, Department of Internal Medicine, University Hospital \u2018Dr Jos\u00e9 E Gonz\u00e1lez\u0092, Universidad Autonoma de Nuevo Le\u00f3n, Monterrey, M\u00e9xico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"7274","container-title":["European Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/touchendocrinology.com\/general-endocrinology\/journal-articles\/case-report-severe-hypercalcaemia-chronic-tophaceous-gout-as-the-responsible-cause\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T07:00:37Z","timestamp":1764745237000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.touchendocrinology.com\/articles\/case-report-severe-hypercalcaemia-chronic-tophaceous-gout-responsible-cause"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015]]}},"alternative-id":["EE.2015.11.02.102"],"URL":"https:\/\/doi.org\/10.17925\/ee.2015.11.02.102","relation":{},"ISSN":["1758-3772"],"issn-type":[{"type":"print","value":"1758-3772"}],"subject":[],"published":{"date-parts":[[2015]]}}}