# Unexplained Gastric Ulcer: Role of Cinacalcet

## TL;DR

A patient with hyperparathyroidism and gastric ulcers showed improvement after reducing cinacalcet, suggesting a possible link between the drug and ulcers.

## Contribution

This case suggests cinacalcet may contribute to gastric ulcers in patients with hyperparathyroidism.

## Key findings

- A 66-year-old male with hyperparathyroidism on cinacalcet developed gastric ulcers.
- Reducing the cinacalcet dose led to complete resolution of gastric inflammation.

## Abstract

Peptic ulcer disease (PUD) most commonly arises as a complication of Helicobacter pylori (H. pylori) or impaired mucosal defense mechanisms against acid exposure by medications such as non-steroidal anti-inflammatory drugs (NSAIDs). Hypercalcemia can present with peptic ulcer-related symptoms, and cinacalcet is an effective medical treatment for primary hyperparathyroidism (PHPT) for non-surgical candidates. We present a case of a 66-year-old male patient with a history of primary hypercalcemia as a result of hyperparathyroidism, on chronic cinacalcet, who was found to have gastric ulcers on endoscopy. After the reduction of the cinacalcet dose in one year, there was a complete resolution of inflammation in the gastric body.