Hypercalcemic Nephropathy in Thyrotoxicosis

The clinical picture in diseases associated with hypercalcemia may be dominated by symptoms due to the hypercalcemia. This dominance is generally observed in those diseases in which hypercalcemia is necessarily present (hyperparathyroidism, vitamin D or AT 10 poisoning, the milk alkali syndrome (Burnett et al., 1949, Scholz & Keating, 1955) and idiopathic hypercalcemia of infancy (Payne & Lightwood, 1952, Creery, 1953, Creery & Neill, 1954, Lowe et al., 1954, Schlesinger et al., 1956)). The symptoms are on the whole less striking in diseases only occasionally complicated by hypercalcemia (sarcoidosis (Klatskin & Gordon, 1953), myelomatosis and other osteolytic, particularly metastatic bone diseases (Albright & Reifenstein, 1948, Snapper, 1952)). Despite the occasional occurrence of demineralization of bone, thyrotoxicosis is only rarely complicated by hypercalcemia. The serum concentrations of calcium and phosphorus in this condition have been described as normal by Teichmann (1951) and Laake (1955) and as slightly reduced by Robertson (1942).