What is the clinical evidence from this study?

Study design: Case Report. Population: Hypercalcemia of unidentified etiology (n=1). Intervention: Severe hypercalcemia.

What question did this study set out to answer?

To describe a rare, fatal case of rapid myocardial calcification resulting from severe hypercalcemia of unknown origin.

August 25, 2026Journal of Medical Case ReportsOpen Access

Rapid progression of myocardial calcification in a patient presenting with hypercalcemia of unidentified etiology: a case report

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Key result

Severe hypercalcemia is linked to rapid, fatal myocardial calcification accelerated by inflammation and myocardial injury.

Why the study?

Few reports describe dynamic changes in myocardial calcification among patients with hypercalcemia, and hypercalcemia with an unidentified cause has rarely been reported.

Key Points

To describe a rare, fatal case of rapid myocardial calcification resulting from severe hypercalcemia of unknown origin.
Clinical, imaging, laboratory, and autopsy evaluations of a 57-year-old Japanese woman presenting with fatigue, acute kidney injury, and severe hypercalcemia.
Diagnostic investigations included intact parathyroid hormone, parathyroid hormone-related protein, vitamin D metabolites, bone marrow biopsy, serial CT, and coronary angiography.
Laboratory testing revealed suppressed intact parathyroid hormone (11 pg/mL), elevated fractional excretion of calcium (12%), and a calcium-phosphate product exceeding 70 on day 6.
Serial CT showed new myocardial calcification appearing from day 9 with rapid diffuse progression, accompanied by coronary microvascular dysfunction and death 22 days after admission.
Autopsy demonstrated extensive multi-organ calcification affecting both the heart and lungs, with prominent calcification of small intramyocardial vessels.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

A 57-year-old Japanese woman with severe hypercalcemia of unidentified etiology who developed rapid and extensive myocardial calcification and died 22 days after admission.

Exposure

Intravenous fluids, calcitonin, denosumab, hemodialysis, veno-arterial extracorporeal membrane oxygenation (ECMO), and continuous hemodiafiltration (CHDF)

Severe hypercalcemia of unidentified etiology can be complicated by rapid and extensive myocardial calcification, leading to fatal cardiac dysfunction.

Limitations

The exact etiology of hypercalcemia remained unidentified despite extensive investigations and autopsy.
Complete pre-admission exposure details could not be fully verified.

Discussion

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Implication

Alerts clinicians to monitor for dynamic calcification in hypercalcemia; leaves open questions on unidentified etiologies and reversibility.

Cite This Study

Hirai et al. (2026) conducted a case report in Hypercalcemia of unidentified etiology (n=1). Severe hypercalcemia was evaluated. Severe hypercalcemia of unidentified etiology can lead to rapid, extensive, and fatal myocardial calcification, potentially accelerated by inflammatory conditions and myocardial injury.

synapsesocial.com/papers/6a8d4a34e8bd2413309bc3c1 https://doi.org/10.1186/s13256-026-06542-6

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Implication

Alerts clinicians to monitor for dynamic calcification in hypercalcemia; leaves open questions on unidentified etiologies and reversibility.

Rapid progression of myocardial calcification in a patient presenting with hypercalcemia of unidentified etiology: a case report

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Rapid progression of myocardial calcification in a patient presenting with hypercalcemia of unidentified etiology: a case report

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

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