Background: Multisystem manifestations of hypercalcemia include stones, painful bones, psychic groans, and abdominal moans. All manifestations in a single patient are extremely rare. Hypercalcemia is often diagnosed incidentally when a high calcium level is detected in blood samples.
Case illustration: Here we present a very rare case of hypercalcemia which presented as supra-refractory status epilepticus and other manifestations in the later phase. A young man’s journey through neurological, pancreatic, and renal manifestations of hypercalcemia, the role of diagnostic imaging in revealing parathyroid adenoma, and interventional radiology in providing the definitive cure and management of complications are explained here.
Conclusion: Careful history and physical examination focusing on the clinical features of hypercalcemia, possible causative diseases, and medication is important. The laboratory workup and correct interpretation help the physician narrow down the differentials. Increased screening of calcium levels and the wide availability of reliable assays for intact parathyroid hormone (PTH) levels have led to more frequent and earlier diagnoses of primary hyperparathyroidism. The role of radiology in hypercalcemia is not limited to diagnosis, but it involves managing complications in each phase and in providing a definitive cure.