Low-trauma Fracture with Hypercalcemia: Need to Look Deeper

Low-trauma Fracture with Hypercalcemia: Need to Look Deeper

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Aim: To emphasize the importance of a timely, systemic approach to hypercalcemia to reach an etiological diagnosis.Background: Hypercalcemia is commonly encountered in many individuals, in both inpatient and outpatient settings.Its evaluation entails careful history taking, a battery of investigations to arrive at an etiological 5mm diagnosis.Hypercalcemia is more common in adults but not uncommon in children and adolescents.Case description: Here, we present a case of an apparently healthy young male presenting with a nontraumatic vertebral fracture who was incidentally detected to have hypercalcemia.

Further evaluation revealed parathyroid hormone (PTH)-independent hypercalcemia.He also had mild anemia and mildly impaired renal function at presentation.During his in-hospital stay, he developed bicytopenia.Bone marrow studies and flow cytometry showed a hypercellular marrow suggestive of acute lymphoblastic leukemia (ALL).Discussion: This case illustrates an uncommon presentation of aleukemic ALL, i.

e., low-trauma fracture with PTH-independent hypercalcemia.Conclusion: Hypercalcemia, especially PTH-independent, should entail a high index of suspicion across all age groups for malignancies, including solid tumors and hematological malignancies.Clinical significance: Malignancies, even in younger individuals, can present with low-trauma Ski de fond - Skis a roulettes fracture and hypercalcemia.