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7 out of 7

Raised calcium and phosphorous seen in: (DNB June 2011)

B Vitamin D intoxication

C Hyperparathyroidism
D Pseudohypoparathyroidism

Ans. B

Vitamin D intoxication

Cause of hypophosphatemia

1. Reduced renal tubular phosphate reabsorption

a. PTH/PTHrP -dependent

i. Hyperparathyroidism

ii. PTHrP-dependent hypercalcemia of malignancy

iii. Familial hypocalciuric hypercalcemia

b. PTH/PTHrP-independent

i. Genetic hypophosphatemia

● X-linked hypophosphatemia rickets

● Wilson disease

ii. Other systemic disorders

● Poorly controlled diabetes mellitus

● Alcoholism

iii. Drugs

● Diuretics

● Cisplatin

● Ifosfamide

● Foscarnet

● Calcitonin

● Pamidronate

2). Impaired intestinal phosphate absorption

Aluminum-containing antacids

3). Shifts of extracellular phosphate into cells

Insulin therapy of prolonged hyperglycemia or diabetic ketoacidosis

Causes of hyperphosphatemia

Decreased renal phosphate excretions

1). ARF,

2). CRF,

3). Hypoparathyroidism,

4). Pseudo Hypoparathyroidism,

5). Bisphosphonates,

6). Acromegaly


1). Vitamin D intoxication

2). Acidosis,

3). Rhabdomyolysis,

4). Cytotoxic therapy

5). tumour lysis

6). Fulminant hepatitis