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Query: UMLS:C0020437 (hypercalcemia)
 10,293 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This 20 year old man suffered increasingly from multifocal bone- and back pain over the last 6 months. Painful weakness of the left leg with dysesthesia of the 4th and 5th toe, a weight loss of 15 kg and polydipsia and pollakiuria had developed. The clinical workup disclosed hard tumors in the right mandible and tibia, a waddling gait with bilateral sign of Trendelenburg, reduced muscular force in the left leg with missing achilles tendon reflex and a loss of sensibility in the distal S1 segment, epigastric tenderness on pressure and hypertension with a value of 160/100 mmHg. X-rays revealed multiple cystic bone lesions at all sites. Hypercalcemia and massively elevated parathyroid hormone were measured. Since the parathyroids were enlarged on sonography, primary hyperthyroidism with fibrosing osteitis v. Recklinghausen was diagnosed.
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PMID:[Bone pain, polydipsia, polyuria]. 818 45

The changes in normal endocrine physiology which accompany pregnancy result in changes in normal ranges of hormone levels and in specific changes in the course and management of endocrine diseases. This review presents information about the various endocrine diseases and their management in pregnant adolescents. Normal pituitary function during pregnancy is described as is the effect of pregnancy on pituitary tumors such as microadenomas and prolactinomas. The effects of bromocriptine therapy in cases where tumor enlargement occurs during pregnancy are tabulated. Methods of distinguishing placental growth hormone secretion and pituitary growth hormone secretion in patients with acromegaly are presented (with the note that acromegalic patients rarely become pregnant). TSH-secreting, gonadotropin, and nonsecreting tumors are rare in this age group, and there is no evidence that they enlarge during pregnancy. The discussion of the pituitary covers chronic hypopituitarism, Sheehan's Syndrome, lymphocytic hypophysitis, and diabetes insipidus. After reviewing normal changes in thyroid physiology during pregnancy, hyperthyroidism (usually due to Graves' disease), thyroid storm, and hypothyroidism are considered. The adrenal is the next subject, with a brief description of normal changes during pregnancy followed by comments on Cushing's Syndrome, adrenal insufficiency, congenital adrenal hyperplasia, and primary hyperaldosteronism. The symptoms, diagnosis, and treatment of pheochromocytomas, which are uncommon during pregnancy but are associated with high fetal and maternal mortality, are the next topics. After a review of changes in calcium metabolism during pregnancy and hypercalcemia, this report ends with a consideration of diabetes mellitus which includes alterations in maternal carbohydrate metabolism during pregnancy, effects of diabetes on the fetus, and management of insulin-dependent diabetes mellitus during pregnancy (the most likely type to be present in adolescents).
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PMID:Endocrine problems of adolescent pregnancy. 824 53

The discovery of a hypercalcemia validated by exclusion of hemoconcentration and follow-up calcium determinations opens the differential diagnosis of a malignancy and of hyperthyroidism whereas drug-induced causes can be recognized easily. A single determination of plasmatic parathyroid hormone (PTH) allows to safely distinguish between PTH-induced or PTH-independent, most often tumor-associated hypercalcemia. In both instances the patient may be free of symptoms particularly the very old one. Therapeutic measures are indicated in both instances: Treatment of malignancy-associated hypercalcemia is clinically effective and treatment of asymptomatic hyperthyroidism is likewise recommended, mainly to preserve bone mass and cerebral performance.
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PMID:[Hypercalcemia as incidental finding--what should be done?]. 829 34

A 39-year-old man was admitted to our hospital complaining of general malaise, polyuria, disturbance of ocular movement and right cervical tumor. Blood examination revealed increased parathyroid hormone, hypercalcemia and hypophosphatemia, suggestive of hyperparathyroidism. Histology of the resected tumor revealed a benign parathyroid adenoma. Ectopic calcifications in the choroid and sclera were noted by computed tomography and further ophthalmological examination. Although ocular calcification in conjunctiva and cornea associated with hyperthyroidism is not unusual, sclerochoroidal calcification has not been reported previously in Japan. The possible cause of this unusual condition in this patient is discussed.
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PMID:Ectopic choroidal calcification of the eyes of a patient with parathyroid adenoma. 849 47

The simultaneous occurrence of hyperthyroidism and primary hyperparathyroidism is rare in the absence of previous neck irradiation. We report two cases from our institution. Hypercalcemia secondary to hyperthyroidism is common and may obfuscate the diagnosis of concomitant primary hyperparathyroidism. Therefore the continued presence of hypercalcemia in a patient with successfully treated hyperthyroidism should lead the physician to search for primary hyperparathyroidism. Treatment of these concomitant disease processes consists of combined thyroidectomy and parathyroidectomy.
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PMID:Coexisting hyperthyroidism and primary hyperparathyroidism. 850 32

A 26-year-old man with Graves' hyperthyroidism associated with central diabetes insipidus (DI), initially showed hypercalcemic crisis. Initially, very low serum levels of intact parathyroid hormone (PTH) and 1,25-dihydroxy vitamin D3 and a moderate rise of serum C-terminal PTH related protein (C-PTHrP) were observed which strongly suggested a humoral hypercalcemia of malignancy due to PTHrP. However, the serum C-PTHrP level later became normal. Mild hyperprolactinemia, no responses of growth hormone (GH) to insulin-induced hypoglycemia despite a normal growth hormone releasing hormone (GRH) test and mild thickening of the pituitary stalk on magnetic resonance imaging were observed. Thus, an autoimmune nature of his central DI is considered; it is noteworthy that the serum C-PTHrP level may be elevated by renal failure in patients with hypercalcemia due to causes other than PTHrP.
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PMID:Development of hypercalcemic crisis in a Graves' hyperthyroid patient associated with central diabetes insipidus. 858 May 71

A patient with hypercalcemia was found to have thyrotoxicosis and no other underlying cause for the elevated serum calcium level. Radioiodine therapy relieved hyperthyroidism and hypercalcemia. We discuss the incidence of hypercalcemia in patients with thyrotoxicosis and mechanisms for hypercalcemia in hyperthyroidism.
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PMID:Hyperthyroidism manifested as hypercalcemia. 886 95

Most patients with hypertension in the United States have essential (primary) hypertension (95%), the cause of which is unknown. The remaining 5% of adults with hypertension have the secondary form of hypertension, the cause and pathophysiologic process of which are known. Internists and other primary care physicians refer to this as treatable or curable hypertension, because the hypertension can be managed or even controlled with medications. Similarly, the condition is called surgical hypertension by surgeons in the belief that once the cause is determined and identified, surgical intervention will result in cure of hypertension. Secondary causes of hypertension include renal parenchymal disease, renovascular diseases, coarctation of the aorta, Cushing's syndrome, primary hyperaldosteronism, pheochromocytoma, hyperthyroidism, and hyperparathyroidism. Occasionally included in this category are alcohol- and oral contraceptive-induced hypertension and hypothyroidism, but these conditions are not discussed herein. The evaluation of secondary hypertension is of interest and can bring together different facets of anatomy, physiology, pharmacology, and radiology in the medical and surgical treatment of these disorders. Despite enthusiasm that can be generated in the evaluation of these conditions, evaluation can be expensive and should not be conducted for all patients with hypertension. Features that aid in the diagnosis of secondary hypertension include the following: 1. Onset of hypertension before the age of 20 or after the age of 50 years. The presence of hypertension at a young age may suggest coarctation of the aorta, fibromuscular dysplasia, or an endocrine disorder. Hypertension found for the first time after the age of 50 years may suggest the presence of renovascular hypertension caused by atherosclerosis. 2. Markedly elevated blood pressure or hypertension with severe end-organ damage, as in grade III or IV retinopathy. These findings suggest the presence of renovascular hypertension or pheochromocytoma. 3. Specific body habitus and ancillary physical findings. For example, truncal obesity and purple striae occur with hypercortisolism, and exophthalmos is associated with hyperthyroidism. 4. Resistant or refractory hypertension (poor response to medical therapy usually necessitating use of more than three antihypertensive medications from three different classes). 5. Specific biochemical test that suggest the existence of certain disorders, such as hypercalcemia in hyperparathyroidism, hyperglycemia in Cushing's syndrome and pheochromocytoma, and unprovoked hypokalemia with renin-producing tumors, primary hyperaldosteronism, or renin-mediated renovascular hypertension. 6. Other characteristics that may suggest secondary hypertension such as abdominal diastolic bruits (renovascular hypertension), decreased femoral pulses (coarctation of the aorta), or bitemporal hemianopias (Cushing's disease). A combination of a good history and physical examination, astute observation, and accurate interpretation of available data usually are helpful in the diagnosis of a specific causation.
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PMID:Secondary hypertension: evaluation and treatment. 894 19

Basic indicators of calcium and bone metabolism and the calcium tolerance test were investigated in patients with untreated hyperthyroidism, Hashimoto's thyroiditis, after total thyroidectomy and in controls. In florid hyperthyroidism elevated values of indicators of bone new formation (osteocalcin and bone fraction of alkaline phosphatases) and of bone resorption (urinary pyridinoline and deoxypyridinoline) were found and a protracted return of the serum calcium level to baseline values (during the 120th minute after completed infusion containing calcium). The calcitonin serum levels were significantly reduced after completion of the infusion up to the 120th minute. These results suggest a reduced calcitonin activity in hyperthyroidism, caused probably by exhaustion of C cells during the prolonged tendency of hypercalcaemia associated with untreated hyperthyroidism. In patients with autoimmune Hashimoto's thyroiditis no significant deviations in basal indicators of the calcium and bone metabolism were found nor deviations of the serum calcium and calcitonin levels during the calcium tolerance test. After total thyroidectomy the basal values of calcitoninaemia are significantly reduced and during the calcium tolerance test the elevated serum calcium level persists from the end of the calcium containing infusion up to the 120th minute. The calcitonin values are at all time intervals significantly low or cannot be detected (during the 120th and 240th minute). Changes of the serum calcium and calcitonin level are due to the surgical removal of the calcitonin source, thyroid C cells. The investigation confirmed the impaired calcium and bone metabolism and impaired calcium tolerance test in hyperthyroidism and in particular after total thyroidectomy. Reduced calcitonin values in these patients can act as a factor promoting the development of osteoporosis.
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PMID:[The calcium tolerance test in thyrotoxicosis, Hashimoto's thyroiditis and after total thyroidectomy]. 898 64

We present here a case of prominent hypercalcemia accompanied by hypothalamic tumor and Graves' disease. A 24-year-old man with hypothalamic tumor showed hypopituitarism, central diabetes inspidus (DI) and hyperthyroidism. Nausea, loss of thirst and appetite, and general fatigue were found with the unveiling of hypercalcemia and hypernatremia. Parathyroid hormone (PTH) and 1alpha-dihydroxyvitamin D levels were suppressed with a normal range of PTH-related protein values. One-desamino-(8-D-arginine)-vasopressin (DDAVP) and half-saline administration normalized hypernatremia, while hypercalcemia was still sustained. Administration of cortisone acetate and thiamazole reduced the elevated serum Ca level. In the present case, concurrent hyperthyroidism was assumed to accelerate skeletal mobilization of calcium into the circulation. Hypocortisolism and central DI was also considered to contribute, to some extent, to the hypercalcemia through renal handling of Ca.
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PMID:Hypercalcemia accompanied by hypothalamic hypopituitarism, central diabetes inspidus and hyperthyroidism. 1041 54


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