Refractory Hypercalcemia in a Jamaican Woman

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Amaris Balitsky MSc, MD
Jonathan So, PhD, MD
Carolyn Chessex, MSc, MD

hypercalcemia, treatment of hypercalcemia, hyperparathyroidism,


The two common differential diagnoses for hypercalcemia are malignancy and hyperparathyroidism. In this case of a young woman with hypercalcemia refractory to bisphosphonate treatment, Vitamin D and parathyroid hormone releasing peptide (PTHrP) levels were normal. She was found to be positive for HTLV-1 and later diagnosed with Adult T-cell leukaemia/ lymphoma, with CNS involvement. After treatment with R-CHOP therapy with intrathecal methotrexate, her symptoms improved and her calcium returned to normal. The differential diagnosis and treatment of hypercalcemia is further discussed.
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