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September 20, 1976

Hypercalcemia and Pancreatitis

Author Affiliations

Miami Beach, Fla

JAMA. 1976;236(12):1352. doi:10.1001/jama.1976.03270130016009

To the Editor.—  The recent interesting report of Gafter et al (235:2004, 1976) on pancreatitis secondary to the hypercalcemia of metastatic malignancy brings to mind an instructive case seen by us a short while ago.A stuporous 70-year-old patient had a serum calcium level of 15.8 mg/100 ml; phosphorus, 5.1 mg/100 ml; creatinine, 2.4 mg/100 ml; and clinical signs of acute pancreatitis. A bone scan and abdominal x-ray films showed no bony abnormalities. The calcium level declined only mildly over two days to 13 mg/100 ml, with hydration, furosemide (Lasix) and steroid therapy and phosphate via nasogastric tube. Severe worsening of the renal insufficiency developed, with an elevation of phosphorus to 8.3 mg/100 ml when the calcium level was 13 mg/100 ml. Since the patient remained seriously ill and stuporous, it was elected to administer calcitonin (Calcimar) in two intramuscular doses of 100 Medical Research Council units each, six hours