title: Refractory hypocalcaemia complicating metastatic prostatic carcinoma.
abstract: A 72-year-old man with a background of ischaemic heart disease was referred to the accident and emergency department with a 1-week history of worsening dyspnoea and lethargy. A chest X-ray revealed a right-sided lobar pneumonia and a prolonged corrected QT interval was noted on his ECG at presentation. Laboratory investigations confirmed severe hypocalcaemia, significant vitamin D deficiency and relative hypoparathyroidism. A markedly elevated prostate-specific antigen was also identified. Bone scintigraphy demonstrated widespread osteoblastic bone metastases. Severe hypocalcaemia persisted despite treatment and he succumbed after 60 days of hospitalisation.
authors.affiliation: Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta Department of Medicine, University of Malta Medical School, Msida, Malta.
authors.forename: Christopher
authors.initials: C
authors.lastname: Rizzo
authors.affiliation: Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta Department of Medicine, University of Malta Medical School, Msida, Malta.
authors.forename: Sandro
authors.initials: S
authors.lastname: Vella
authors.affiliation: Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta Department of Medicine, University of Malta Medical School, Msida, Malta.
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Cachia
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary*; D002118:Calcium / Q000097:blood / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D007011:Hypoparathyroidism / Q000097:blood / Q000150:complications; D008297:Male; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000150:complications* / Q000473:pathology; D017211:Treatment Failure; D014807:Vitamin D / Q000097:blood / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications
chemical_list: D014807:Vitamin D; D017430:Prostate-Specific Antigen; D002118:Calcium