Secondary adrenal failure and secondary amenorrhoea following hydromorphone treatment

© 2007 The Authors Journal compilation © 2007 Blackwell Publishing Ltd, Clinical Endocrinology , 66 , 602–605 prevented by concomitant thyroidectomy. 3 Furthermore, commencement of thyroxine for primary hypothyroidism can cause life-threatening hypercalcaemia in patients with untreated Addison’s disease. 4 Our patient’s mild thyrotoxicosis per se is unlikely to explain the severity of hypercalcaemia. In a report of 437 patients with thyrotoxicosis, 8·5% had serum calcium levels above 2·65 mmol/l and the highest calcium of 2·8 mmol/l was found in a patient with coexisting primary hyperparathyroidism. 5

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