CYCLICAL ETIDRONATE AND CALCIUM-CARBONATE (WITH CITRATE) SUPPLEMENTATION FOR OSTEOPOROSIS UNMASKING PRIMARY HYPERPARATHYROIDISM

An 88 year old lady undergoing cyclical etidronate and calcium carbona te (with citrate) therapy for vertebral osteoporosis was found to be s ymptomatically hypercalcaemic at the end of the first cycle of treatme nt. She had been previously asymptomatic and normocalcaemic, but was s ubsequently found to have primary hyperparathyroidism. This condition is most prevalent in postmenopausal females - the same patient group a t risk of osteoporosis. Serum calcium should be measured after commenc ing cyclical etidronate and calcium carbonate. If hypercalcaemia is de tected primary hyperparathyroidism should be excluded as an underlying , cause.