{
  "abstract": "Background/Objective: Severe hypercalcemia is commonly associated with malignancy and, less frequently, with excessive calcium and vitamin D intake. Management is particularly challenging in patients with underlying disorders of calcium homeostasis. We present a case highlighting the complexities of treating hypercalcemia following discontinuation of denosumab in a patient with malignancy and underlying familial hypocalcemia on long-term calcium supplementation.\n\nCase Report: A 70-year-old woman with metastatic breast cancer and underlying familial hypocalcemia on chronic calcium and active vitamin D supplementation presented with hypercalcemic crisis following discontinuation of long-term denosumab therapy. She was treated with intravenous hydration and 2 doses of calcitonin, which led to a rapid decline in serum calcium levels and subsequent profound hypocalcemia requiring reinitiation of supplementation. Shortly after discharge, she was readmitted with recurrent hypercalcemia, again treated with 1 dose of calcitonin, followed by recurrent hypocalcemia. She was ultimately stabilized with careful titration of calcium and active vitamin D therapy.\n\nDiscussion: This case highlights several important clinical considerations, including the patient’s familial history, oncologic history, the underlying mechanisms contributing to abrupt shifts in calcium levels, and strategies for effective management.\n\nConclusion: Treating hypercalcemia in patients with underlying hypocalcemia disorders can be challenging. Clinicians should take in consideration the complex pathophysiology of their disorder and monitor calcium closely to prevent hypocalcemia.",
  "abstract_shown": true,
  "affiliations": [
    "SUNY Downstate Health Science University, Brooklyn, New York",
    "Division of Endocrinology, Department of Medicine, Maimonides Medical Center, Brooklyn, New York"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhanna Zavgorodneva"
    },
    {
      "affs": [
        1
      ],
      "name": "Jocelyne Karam"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9qtrbn6mc3gqj.bib",
  "cited_by": 0,
  "doi": "10.1016/j.aed.2026.06.001",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13728278/",
  "id": "9qtrbn6mc3gqj",
  "issns": [
    "3050-9157"
  ],
  "landing_url": "https://doi.org/10.1016/j.aed.2026.06.001",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2727|Parathyroid Disorders and Treatments"
    ]
  ],
  "openalex": "W7163888089",
  "pdf_url": "https://www.endocrinologydiabetes.org/article/S3050-9157(26)00119-0/pdf",
  "pmcid": "PMC13728278",
  "pmid": "42978804",
  "published": "2026-06-08",
  "publisher": "American Association of Clinical Endocrinology",
  "ris": "https://research.draconitic.com/paper/9qtrbn6mc3gqj.ris",
  "sources": [
    {
      "first_seen": "2026-11-06T12:23:59Z",
      "native_id": "PMC13728278",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.aed.2026.06.001"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2712|Thyroid Disorders and Treatments",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Severe Hypercalcemia Followed by Profound Hypocalcemia in a Patient With Familial Hypocalcemia and Metastatic Cancer",
  "title_text": "Severe Hypercalcemia Followed by Profound Hypocalcemia in a Patient With Familial Hypocalcemia and Metastatic Cancer",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:18Z",
  "url": "https://research.draconitic.com/paper/9qtrbn6mc3gqj",
  "venue": "AACE Endocrinology and Diabetes",
  "versions": []
}