Shingles (varicella zoster) outbreaks in patients with hyperparathyroidism and their relationship to hypercalcemia.

Shingles (varicella zoster) can be a presenting symptom of hyperparathyroidism and occurs twice as often (rate, 3.7%) among patients with hypercalcemia than in age-matched cohorts of patients >40 years of age who have normal calcium levels. The incidence of shingles increased in a linear fashion, from an annual rate of 1.5% among patients with serum calcium levels <10.5 mg/dL to 11% among patients whose calcium levels reached 13 mg/dL (P<.05), a rate that is 6 times greater than that among age-matched historical control individuals (P<.05).