SECONDARY HYPOADRENALISM PRESENTING WITH HYPERCALCEMIA

We describe a young woman with lymphocytic hypophysitis presenting in the early post-partum period. She had selective corticotroph failure c ausing secondary adrenal insufficiency. At the time of presentation sh e had transient hyperthyroidism due to thyroiditis, and hypercalcaemia . This is the third case to be described of hypercalcaemia occurring i n association with lymphocytic hypophysitis. Hypercalcaemia is not a r ecognized complication of other forms of pituitary failure. The two pr eviously described cases also had selective corticotroph failure and h yperthyroidism due to thyroiditis. This pattern of presentation suppor ts the concept that thyroid hormone action in the presence of glucocor ticoid deficiency is responsible for the increased calcium efflux from bone into the circulation. Reduced renal excretion of calcium due to a reduction in calcium delivery to the glomerulus and increased proxim al tubular reabsorption are also implicated in the aetiology of hyperc alcaemia associated with adrenal failure.