ABSTRACT
Multiple symptoms arise when disease leads to hyper-or hypocalcemia and Clinical Case 5.1 illustrates features of hypercalcemia.
Clinical Case 5.1 is a middle-aged woman suffering from the consequences of marked hypercalcemia, presenting with symptoms of polydipsia and polyuria. These, together with the weight loss, made her primary care physician suspect DM. However, this patient had anorexia whilst DM is much more commonly associated with a good appetite, despite weight loss. The polyuria resulted from the effects of hypercalcemia antagonizing the action of arginine vasopressin on the distal tubule and collecting ducts of the kidney (see Box 7.42). The resulting diuresis stimulated thirst and led to polydipsia. Her anorexia was due to the effects of hypercalcemia acting on the brain to reduce appetite.
