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"Hypercalcaemia" OR "Hypercalcemia" AND "Treatment"

Nandakrishna Bolanthakodi, Sudha Vidyasagar, Muralidhar Varma, Avinash Holla
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity described by Hinchey et al in late 90's, characterised by variable associations of seizure activity, consciousness impairment ranging from confusion to coma, headaches, visual abnormalities, nausea/vomiting and focal neurological signs. Common causes are accelerated hypertension, eclampsia, preeclampsia, cytotoxic drug use and autoimmune diseases like systemic lupus erythematosus.We report a case of PRES in a 62-year-old female patient due to hypercalcemia secondary to vitamin D toxicity on treatment with calcium supplements and vitamin D for secondary hypoparathyroidism...
February 11, 2019: BMJ Case Reports
Korcan Demir, Hakan Döneray, Cengiz Kara, Zeynep Atay, Semra Çetinkaya, Atilla Çayır, Ahmet Anık, Erdal Eren, Ahmet Uçaktürk, Gülay Can Yılmaz, Ayça Törel Ergür, Mustafa Kendirci, Zehra Aycan, Abdullah Bereket, Murat Aydın, Zerrin Orbak, Behzat Özkan
BACKGROUND/AIMS: No large study has been conducted so far to compare the efficiencies of prednisolone, alendronate, and pamidronate as first-line treatment in children with hypercalcemia due to vitamin D intoxication. We aimed to perform a multicenter, retrospective study assessing clinical characteristics and treatment results. METHODS: A standard questionnaire was uploaded to an online national database system to collect data of children with hypercalcemia (serum calcium level >10...
November 5, 2018: Journal of Clinical Research in Pediatric Endocrinology
Gnanaselvam Pamathy, Umesh Jayarajah, Tshering Wangmo, Anura S K Banagala
Lithium induced primary hyperparathyroidism is an uncommon endocrine side effect of long term lithium therapy. We studied the case of a 67-year-old female patient on long term lithium therapy for bipolar affective disorder, who developed resistant hypercalcaemia and parathyroid adenoma which required parathyroidectomy. Furthermore, the effect of chronic lithium therapy on parathyroid glands and serum calcium levels, its pathogenesis, and management were reviewed. Periodic monitoring of serum calcium levels in patients on long term lithium therapy should be practiced...
July 2018: Indian Journal of Psychological Medicine
M Jalbert, A Mignot, A-S Gauchez, A-C Dobrokhotov, J Fourcade
INTRODUCTION: Hypercalcemia is not a rare event and can lead to severe consequences. Its main etiologies are primary hyperparathyroidism and neoplasic conditions. The iatrogenic etiology by vitamin D intoxication is more rarely found. CASE PRESENTATION: A 76-year-old finish woman comes to the emergency room for chest pain. Her medical history is impossible to specify due to the language barrier and initial confusion. She has severe hypercalcaemia (4.14mmol/L), renal insufficiency, cardiac arrhythmia later complicated by an ischemic cardiac episode...
June 2018: Néphrologie & Thérapeutique
Hernan Valdes-Socin, Matilde Rubio Almanza, Mariana Tomé Fernández-Ladreda, Daniel Van Daele, Marc Polus, Marcela Chavez, Albert Beckers
Neuroendocrine tumors (NETs) can secrete hormones, including ectopic secretions, but they have been rarely associated with malignant hypercalcemia. A 52-year-old man with a history of diabetes mellitus was diagnosed with a pancreatic tumor. A pancreatic biopsy confirmed a well-differentiated pancreatic NET (pNET). The patient subsequently developed liver metastasis and hypercalcemia with high 1,25 OH vitamin D and suppressed parathyroid hormone (PTH) levels. Hypercalcemia was refractory to chemotherapy, intravenous saline fluids, diuretics, calcitonin and zoledronate...
2017: Archives of Endocrinology and Metabolism
Naourez Kolsi, Sondos Jellali, Jamel Koubaa
Parathyroid carcinoma is a very rare malignant tumor of the parathyroid gland. Clinically, this cancer is characterized by the presence of severe primary hyperparathyroidism. Diagnosis is based on histological examination but is not always easy. Surgery is the treatment of choice. We report the case of a 59-year old woman with a personal history of arterial hypertension and of recurrent renal lithiasis, presenting with diffuse bone pain associated with asthenia. Neck examination showed hard basi-cervical swelling with nonpalpable lower edge...
2017: Pan African Medical Journal
Jeremy J O Turner
Hypercalcaemia is a common disorder normally caused by primary hyperparathyroidism (PHPT) or malignancy. A proportion of cases present as an emergency, which carries a significant mortality. Emergency management of hypercalcaemia is based on intravenous rehydration with normal saline but when this is inadequate, bisphosphonate therapy is used; more recently the novel anti-resorbtive agent denosumab has been shown to have a useful role in treatment. It is estimated that up to 10% of all cases of PHPT presenting under the age of 45 years have an underlying genetic predisposition; nine potentially causative genes are now recognised and may be screened in routine clinical practice...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
Michael V Linstow, Fin Biering-Sørensen
INTRODUCTION: Immobilisation-induced hypercalcemia following SCI affecting the kidney function, is a rare but potentially serious condition. We report immobilisation-induced hypercalcemia affecting the kidney function in two young native Greenlanders with spinal cord injury (SCI). CASE PRESENTATIONS: Two 15- and 24-year-old male native Greenlanders, both with traumatic C5 SCI were admitted to our spinal cord unit. They were non-smokers without history of daily alcohol intake pre- or immediately post-injury...
2017: Spinal Cord Series and Cases
B Désirée Ballhausen, Astrid Wehner, Martin Zöllner, Katrin Hartmann, Stefan Unterer
Hypercalcaemia can be caused by many different diseases. This article summarizes the causes, pathophysiologic mechanisms and diagnostic procedures as well as treatment recommendations. The main focus is on hypercalcaemia in primary hyperparathyroidism (PH), complemented by a case report. An elevated total calcium level should generally be investigated and verified by measurement of ionized calcium concentration. The further diagnostic approach depends on the phosphate level. Tumour screening, measurement of parathormone and parathromone-related protein and sonography of parathyroid glands may be necessary...
April 19, 2017: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
Marta Roqué I Figuls, Maria José Martinez-Zapata, Martin Scott-Brown, Pablo Alonso-Coello
BACKGROUND: This is an update of the review published in Issue 4, 2003. Bone metastasis cause severe pain as well as pathological fractures, hypercalcaemia and spinal cord compression. Treatment strategies currently available to relieve pain from bone metastases include analgesia, radiotherapy, surgery, chemotherapy, hormone therapy, radioisotopes and bisphosphonates. OBJECTIVES: To determine efficacy and safety of radioisotopes in patients with bone metastases to improve metastatic pain, decrease number of complications due to bone metastases and improve patient survival...
March 23, 2017: Cochrane Database of Systematic Reviews
Megan Symington, Louise Davies, Gregory Kaltsas, Martin O Weickert
A 54-year-old woman presented to our centre with acute abdominal pain and vomiting. Routine blood tests showed severe hypercalcaemia (>4 mmol/L). Serum parathyroid hormone (PTH) was suppressed. CT scan detected a pancreatic mass and some liver lesions, initially suspicious for metastatic pancreatic adenocarcinoma. Liver biopsy however revealed the presence of a well-differentiated, grade 1, metastatic neuroendocrine tumour (NET) where prognosis is considerably better. Serum PTHrP was raised, indicating paraneoplastic hypercalcaemia, most likely secondary to the pancreatic NET...
March 22, 2017: BMJ Case Reports
Shogo Hanai, Takashi Shinzato, Daiki Inazu, Yasuharu Tokuda
Many diseases can cause hypercalcaemia, including primary hyperparathyroidism, cancer, drugs and granulomatous diseases. A nursing home resident aged 81 years was admitted because of altered mental status. The patient did not have fever, cough, sputum or night sweat. Hypercalcaemia was identified as a cause of the consciousness disturbance. Chest radiograph showed no acute process. Laboratory workups revealed elevated serum levels of 1,25-(OH)2 vitamin D3 and positive T-spot test. Microscopic examination of the suctioned sputum identified acid-fast bacilli, which was confirmed as Mycobactrium tuberculsosis Tuberculosis should be considered as the important cause of hypercalcaemia since early diagnosis and treatment is recommended for preventing its outbreak among people with close contacts with patients...
February 24, 2017: BMJ Case Reports
Ke Chen, Yanhong Xie, Liling Zhao, Zhaohui Mo
RATIONALE: Hyperthyroidism is one of the major clinical causes of hypercalcaemia, however, hyperthyroidism-related hypercalcemic crisis is rare, only 1 case have been reported. The potential mechanisms are still not too clear. It may be related that thyroid hormone stimulate bone turnover, elevate serum calcium, increase urinary and fecal calcium excretion. PATIENT CONCERNS: A 58-year-old female patient was found to have Graves' disease, a marked elevated serum calcium level (adjusted serum calcium: 3...
January 2017: Medicine (Baltimore)
Hooi Khee Teo, Jiunn Wong
Immobility-induced hypercalcaemia is rarely considered in patients on dialysis and is a challenging diagnosis to make. This is especially so due to the lack of biomarkers as well as the notion that calcium metabolism is mostly related to chronic kidney disease-metabolic bone disorder due to the role of iPTH. We present two cases of our dialysis patients, who were clinically unwell from hypercalcemia. We were initially uncertain of the cause of hypercalcemia as despite our attempts to adjust treatment based on their biochemical findings, we were unable to correct the hypercalcemia...
April 2017: Hemodialysis International
Jennie Walker
Primary hyperparathyroidism is a common endocrine disorder that results in elevated levels of parathyroid hormone and subsequent hypercalcaemia. Nurses have an important role in the support, education and care of the older person undergoing surgical or conservative treatment. Knowledge of pathophysiology is essential to ensure complications of hyperparathyroidism are identified promptly and managed appropriately alongside existing healthcare needs.
July 2016: Nursing Older People
Michael P Whyte
Hypophosphatasia is the inborn error of metabolism characterized by low serum alkaline phosphatase activity (hypophosphatasaemia). This biochemical hallmark reflects loss-of-function mutations within the gene that encodes the tissue-nonspecific isoenzyme of alkaline phosphatase (TNSALP). TNSALP is a cell-surface homodimeric phosphohydrolase that is richly expressed in the skeleton, liver, kidney and developing teeth. In hypophosphatasia, extracellular accumulation of TNSALP natural substrates includes inorganic pyrophosphate, an inhibitor of mineralization, which explains the dento-osseous and arthritic complications featuring tooth loss, rickets or osteomalacia, and calcific arthopathies...
April 2016: Nature Reviews. Endocrinology
Adam Orville Strand, Thein Tun Aung, Ajay Agarwal
ST-segment elevation myocardial infarction is an important, life-threatening diagnosis that requires quick diagnosis and management. We describe the case of an 83-year-old man with coronary artery disease, ischaemic cardiomyopathy with left ventricular ejection fraction of 15%, newly diagnosed multiple myeloma that had an initial ECG showing ST-segment elevation in anterior leads V1-3 and ST-segment depression in lateral leads concerning for an ST-segment elevation myocardial infarction. Troponins were negative and his calcium was 3...
October 13, 2015: BMJ Case Reports
Ovie Edafe, Jonathan Webster, Malee Fernando, Ragu Vinayagam, Sabapathy P Balasubramanian
We report a case of phaeochromocytoma associated with hypercortisolism and hypercalcaemia in a 62-year-old man. The patient presented to clinic, with a 3-year history of exertional headaches, and a 4-month history of increasing fatigue, sweating and palpitations, loss of appetite and weight, and sleepiness. He did not have a medical, family or social history that could account for these symptoms. 24 h urinary catecholamines, plasma metanephrines, 24 h urinary cortisol and adjusted serum calcium, were elevated...
October 7, 2015: BMJ Case Reports
Shreyashee Mallik, Girijasankar Mallik, Shireen Teves Macabulos, Andrew Dorigo
BACKGROUND: Hypercalcaemia is a potentially fatal paraneoplastic complication of malignancy. It primarily manifests during the advanced phase of cancer, with the life expectancy of patients ranging from weeks to months. The mainstay of treatment is with bisphosphonates, but these are not frequently used in a palliative population due to potential conflict with goals of care. GOAL: The goals of this study was to determine the reversibility of hypercalcaemia amongst patients whose underlying malignancy is not being treated and assess whether correction results in improvement in symptoms attributable to hypercalcaemia, while identifying risk factors that can predict responsiveness...
April 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
R Kallala, F S Haddad
Periprosthetic joint infection (PJI) is a devastating complication for patients and results in greatly increased costs of care for both healthcare providers and patients. More than 15 500 revision hip and knee procedures were recorded in England, Wales and Northern Ireland in 2013, with infection accounting for 13% of revision hip and 23% of revision knee procedures. We report our experience of using antibiotic eluting absorbable calcium sulphate beads in 15 patients (eight men and seven women with a mean age of 64...
September 2015: Bone & Joint Journal
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