DOI: 10.12890/2025_005169

Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation

Authors

  • Christodoulos Dolapsakis 4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
  • Emmanouil Karofylakis 4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
  • Stamatios Chalvatzis 4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece

dolapsak@yahoo.gr

Keywords

SGLT2 inhibitors, hypercalcemia, hyperparathyroidism

Abstract

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have complex interactions with bone metabolism, including an increase in parathyroid hormone (PTH) levels. Here we report a case of a SGLT2 inhibitor-induced hypercalcemia due to primary hyperparathyroidism. In the subset of patients with normocalcemic primary hyperparathyroidism, SGLT2 inhibitor initiation can unmask the disorder causing overt hypercalcaemic hyperparathyroidism. Although normocalcemic primary hyperparathyroidism is a rare entity, we propose obtaining a baseline PTH level before starting a SGLT2 inhibitor in patients with calcium levels in the upper limit of normal and normal total 25-hydroxyvitamin D levels, especially if they are under vitamin D supplementation. PTH should be rechecked in order to exclude overt primary hyperparathyroidism.

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References

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Published

2025-01-29

Issue

Vol. 12 No. 2 (2025)

Categories

How to Cite

1.
Dolapsakis C, Karofylakis E, Chalvatzis S. Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation. EJCRIM [Internet]. 2025 Jan. 29 [cited 2026 Nov. 3];12(2). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5169

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