Hypercalcemia accompanied by hypothalamic hypopituitarism, central diabetes inspidus and hyperthyroidism

We present here a case of prominent hypercalcemia accompanied by hypothalam ic tumor and Graves' disease. A 24-year-old man with hypothalamic tumor sho wed hypopituitarism, central diabetes inspidus (DI) and hyperthyroidism. Na usea, loss of thirst and appetite, and general fatigue were found with the unveiling of hypercalcemia and hypernatremia. Parathyroid hormone (PTH) and la-dihydroxyvitamin D levels were suppressed with a normal range of PTH-re lated protein values. One-desamino-(8-D-arginine)-vasopressin (DDAVP) and h alf-saline administration normalized hypernatremia, while hypercalcemia was still sustained. Administration of cortisone acetate and thiamazole reduce d the elevated serum Ca level, In the present case, concurrent hyperthyroid ism was assumed to accelerate skeletal mobilization of calcium into the cir culation. Hypocortisolism and central DI was also considered to contribute, to some extent, to the hypercalcemia through renal handling of Ca.