Hyperparathyroidism in a Patient with Autoimmune Polyglandular Syndrome

• Published in: Internal Medicine Vol. 47; no. 21; pp. 1911 - 1915
• Main Authors: Pelletier-Morel, Lorraine, Fabien, Nicole, Mouhoub, Yamina, Boitard, Christian, Larger, Etienne
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-01-2008
• Subjects: Autoantibodies - blood; autoimmune polyglandular syndrome; calcium-sensing receptor autoantibodies; diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - diagnosis; Humans; hypercalcemia; Hyperparathyroidism - blood; Hyperparathyroidism - complications; Hyperparathyroidism - diagnosis; Male; Middle Aged; Polyendocrinopathies, Autoimmune - blood; Polyendocrinopathies, Autoimmune - complications; Polyendocrinopathies, Autoimmune - diagnosis; thyroiditis; type 1
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.47.1355

Autoimmune hypercalcemia has been reported in only a few cases, and never in the context of autoimmune polyglandular syndrome. A patient with type 1, insulin-dependent diabetes mellitus, Graves' disease, and antiparietal cell antibodies presented with persistent hypercalcemia with inappropriate PTH secretion. Other causes of hypercalcemia were excluded. In this context of two associated organ-specific autoimmune diseases we searched for autoantibodies directed to parathyroid tissue and to calcium-sensing receptor. Anti-parathyroid autoantibodies were detected by indirect immunofluorescence on parathyroid adenomas, and autoantibody against a peptide of the extracellular domain of the calcium-sensing receptor were detected by immunoblotting. Autoimmune hypercalcemia may be another organ-specific feature of autoimmune polyglandular syndrome.