A Rare Case Of Liver Disease Induced Hypercalcemia: Case Presentation And Review Of The Literature

Hypercalcemia induced by advanced chronic liver disease without hepatoma is an exquisitely rare condition, poorly understood, with only 17 cases described to date in the literature. We describe the case of a 36 year old African American man with sickle cell disease, chronic liver disease secondary to sickle cell hepatopathy complicated by acute liver failure induced by congestive hepatopathy following a severe episode of sickle cell crisis. The patient was transferred to our center to be evaluated for liver transplantation. While in the hospital he developed hypercalcemia. Our extensive search for a “classical” etiology of hypercalcemia was negative. The calcium rapidly returned to normal with calcitonin followed by a small dose of bisphosphonate and recovering of the liver function. Liver disease induced hypercalcemia is a diagnosis of exclusion and responds well to bisphosphonate treatment.