Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020437 (hypercalcemia)
 10,293 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 84-year-old man with non-Hodgkin's malignant lymphoma presented with a pathological fracture of the femur and also an intra-atrial mass on echocardiography. The patient was given palliative low-dose chemotherapy, but died of tumor dissemination, hypercalcemia, and dehydration. Autopsy revealed diffuse large B-cell lymphoma involving multiple bones and lymph nodes (the latter were not detected during staging), and a solitary mass on the posterior wall of the right atrium. This rare lesion appeared to be due to hematogenous spread, since the myocardium and pericardium were free of tumor infiltration. A literature review indicated that the frequency of cardiac involvement differed between contemporary and earlier reports, mainly due to the availability of increasingly sophisticated diagnostic methods and improvements in chemotherapy.
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PMID:Non-Hodgkin's malignant lymphoma of the bone with intracavitary cardiac involvement. 824 97

Renal failure is a frequent complication in multiple myeloma and it is present in about 50% of patients with newly-diagnosed multiple myeloma. Renal failure at the time of diagnosis has earlier been associated with a bad prognosis, but a better prognostic factor is the response to chemotherapy. In general, it is important to distinguish between 1) renal insufficiency at the time of diagnosis, 2) acute renal insufficiency and 3) chronic renal insufficiency developing during the course of the disease. The patients in the first two groups are treated with intensive therapy which is long-lasting (median four to six weeks). The improved function of the kidney is correlated to an improved survival. Patients developing chronic renal insufficiency late in the course of the disease should receive palliative therapy. The most important factors that provoke acute renal insufficiency are dehydration, hypercalcaemia and/or infection, but renal insufficiency is also provoked by the use of nephrotoxic drugs, hyperuricaemia and/or hyperviscosity. Chronic renal insufficiency is provoked by deposits of light chains, infiltration by plasma cells or deposits of amyloid. The treatment consists of elimination of the provoking factors and start of chemotherapy.
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PMID:[Renal insufficiency in myelomatosis. Causes and treatment]. 825 82

In our Internal Medicine department, we conducted a retrospective study of prognostic factors in patients with malignant hypercalcaemia. The records of 51 patients who had both hypercalcaemia and a histologically proven cancer were analyzed; 42 had a solid tumour and 9 had a myeloma. In 61% of the patients cancer had been revealed by hypercalcaemia. The main warning signs were alteration of the general condition (68.6%), pain in the bones (54.9%) and polyuria with dehydration (58.8%). Osteolysis was observed in 75% of the cases. The overall median survival was 86 days. Patients with myeloma had a significantly longer survival than patients with other tumours (312 versus 60 days; p < 0.05). Patients who had received a causal treatment had a longer survival (176 versus 36 days, p < 0.001). In patients with solid tumours we found a negative correlation between survival and initial calcaemia, and a positive correlation between phosphoraemia, albuminaemia and survival. Multivariate analysis showed that the initial calcaemia level and the possibility of causal treatment were the two cardinal prognostic factors. Although the overall survival rate is mediocre, we believe that hospitalization of patients with malignant hypercalcaemia is justified for their better survival comfort and for the possibility of discovering a neoplasia that could benefit from an effective causal treatment, which is the principal factor of improved prognosis.
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PMID:[Neoplastic hypercalcemia: prognostic factors of survival of patients; from 51 cases seen in internal medicine]. 837 34

The first-choice treatment of primary hyperparathyroidism is surgical removal of abnormal parathyroid gland(s) and the medical management is usually reserved only to control severe hypercalcemia. However, asymptomatic primary hyperparathyroidism with mild hypercalcemia and renal and bone status close to normal is now the more common picture of the disease and in this situation conservative management can be considered, because many of those patients may have a prolonged benign course. Management guidelines are therefore devised to minimize the risk for deterioration of renal, skeletal or gastrointestinal complications of hyperparathyroidism. General medical management includes recommendation to avoid dehydration, immobilization or excessive dietary calcium intake and therapy with thiazides; intravenous infusion with isotonic saline combined to furosemide or etacrinic acid are recommended to treat acute or threatening hypercalcemia. Many other drugs as phosphate, mithramycin, gallium nitrate and calcitonin have been reported to be useful in reversing hypercalcemia but their transient effects, toxicity and side effects limit their clinical use. The bisphosphonates, a new class of bone resorption inhibitors, have been shown to be particularly safe so they result especially effective on controlling acute hypercalcemia and on preventing "hungry bone" disease. However, their effect is not sustained because the serum calcium tends to return toward pretreatment levels despite continued therapy; therefore their consistent beneficial effect on long-term treatment seems unlike.
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PMID:[The medical treatment of primary hyperparathyroidism]. 848 34

Analysis of the factors influencing the prognosis of acute renal failure was carried out in cases experienced during the past 10 years. The factors presumed directly affecting the renal function (acute insults) and coexistent predisposing factors (risk factors) were analysed. The followings were considered to be acute insults: surgery/trauma/burn, drug intoxication, sepsis, hypotension, dehydration, rhabdomyolysis, hepatorenal syndrome, and hypercalcemia/hyperuricemia. Suspected risk factors included age, urine volume, underlying disorders/complications. Risk factors rather than acute insults were related to the outcome of acute renal failure. The mortality rate increased as the associated risk factors increase in number. In non-oliguric cases, maximum serum creatinine level was lower than the anuric cases, however there was no difference in the duration of the impaired renal function between 2 groups. In survival cases, the factors affecting the time for the recovery of renal function were also studied, but no definite factors could be determined.
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PMID:[Clinical analysis of the factors affecting the prognosis of acute renal failure]. 850 61

After surgical resection for rectosigmoid carcinoma a 63-year-old man had secretory diarrhea causing severe metabolic acidosis, hypokalemia, hypercalcemia and dehydration. Subsequent investigations revealed a mass measuring 4 x 5 cm in the uncinate process of the pancreas and an elevated vasoactive intestinal polypeptide concentration. The diarrhea responded to treatment with the somatostatin analogue. Sandostatin, and remained under control during a prolonged preoperative period. The patient underwent a Whipple procedure with immediate lessening of his diarrhea. This report illustrates a classic case of vipoma and demonstrates the need to consider this condition in the differential diagnosis of secretory diarrhea, even in the presence of other gastrointestinal lesions. The effectiveness of somatostatin analogues in stabilizing the diarrhea preoperatively is also well illustrated.
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PMID:Surgical treatment of pancreatic cholera: a case report. 876 28

Nitrogen retention of various intensity was found in 61 patients with multiple myeloma. In seven (11%) of them the disturbances of the depurative renal function manifested as acute renal failure (ARF). The syndrome was characterised in etiologic, pathogenetic, clinical, therapeutic and prognostic aspects. ARF in the study developed on the background of a light chain proteinuria in patients with hypercalcemia, dehydration, radiocontrast studies, blood loss, surgical interventions, and severe infections. Following conservative treatment, the renal function normalized in one patient, a gradual transition to chronic renal failure was observed in five patients, and lethal outcome in one patient. The average survival rate after ARF was 8 months (1-13 months).
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PMID:Acute renal failure in patients with multiple myeloma. 900 62

The present study is a retrospective chart analysis of 33 patients who satisfied the diagnostic criteria of multiple myeloma. Sixteen (49.5%) of these 33 patients developed renal failure at some point in time. The mean age +/- 1SD of patients who developed renal failure was 59.2 +/- 13 years (range 34-85 years). There were 12 males and 4 females. The precipitating factors for renal failure were dehydration (12.5%), hypercalcemia (62.5%) and use of non-steroidal antiinflammatory drugs (6.2%). Hypercalcemia was observed in 10 of the 16 patients who developed renal failure while it was seen in only 4 of the 17 cases who did not develop renal failure (relative risk 5.4). In 11 (68.7%) patients, the renal function improved with hydration, treatment of hypercalcemia and chemotherapy. The 1 and 3 year actuarial survival of patients with renal failure and multiple myeloma was 87% and 74% respectively.
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PMID:Renal involvement in multiple myeloma. 925 92

Hyperparathyroidism is a common cause of hypercalcemia. The hypercalcemia usually is discovered during a routine serum chemistry profile. Often, there has been no previous suspicion of this disorder. In most patients initially believed to be asymptomatic, previously unrecognized symptoms resolve with surgical correction of the disorder. The symptoms of hyperparathyroidism are vague and often similar to symptoms of depression, irritable bowel syndrome, fibromyalgia or stress reaction. Complications of primary hyperparathyroidism include peptic ulcers, nephrolithiasis, pancreatitis and dehydration. Surgical management is usually indicated. When medical management is used, routine monitoring for clinical deterioration is recommended. Preoperative localization of adenomas with technetium Tc 99m sestamibi scan is possible but may be unnecessary. An experienced surgeon should perform the parathyroidectomy.
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PMID:Hyperparathyroidism. 957 20

This report describes a forty-seven-year-old female patient with a complex medical history. She was suffering from an unspecified interstitial lung disease, papillary thyroid carcinoma which had been treated, hypoparathyroidism after thyroidectomy for which she was receiving dihydrotachysterol and calcium, and atrial fibrillation and congestive heart failure as a result of mitral stenosis. Shortly after mitral valve replacement she developed a severe hypercalcemia (serum calcium 5.95 mmol/l) during a febrile illness. At that time anti-tuberculous agents were also being administered for presumed tuberculosis. The possible mechanisms for this severe elevation of the calcium level are discussed. Immobilization, while Paget's bone disease was present, and perhaps enhanced activation of dihydrotachysterol by rifampicin, could have led to increased calcium-release into the circulation. Continuous supplecation of calcium and vitamin D, provoked dehydration and the mechanism of the milk-alkali syndrome also contributed to this extremely high calcium level. It is concluded that hypoparathyroid patients being treated with vitamin D and calcium should be carefully monitored in the case of an intercurrent illness or a change in medication.
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PMID:Unaccountable severe hypercalcemia in a patient treated for hypoparathyroidism with dihydrotachysterol. 1004 91


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