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

Systemic fungal infections are increasingly reported in immunocompromised patients with hematological malignancies, recipients of bone marrow and solid organ allografts, and patients with AIDS. Mycoses may infiltrate endocrine organs and adversely affect their function or produce metabolic complications, such as hypopituitarism, hyperthyroidism or hypothyroidism, pancreatitis, hypoadrenalism, hypogonadism, hypernatremia or hyponatremia, and hypercalcemia. Antifungal agents used for prophylaxis and/or treatment of mycoses also have adverse endocrine and metabolic effects, including hypoadrenalism, hypogonadism, hypoglycemia, dyslipidemia, hypernatremia, hypocalcemia, hyperphosphatemia, hyperkalemia or hypokalemia, and hypomagnesemia. Herein, we review how mycoses and conventional systemic antifungal treatment can affect the endocrine system and cause metabolic abnormalities. If clinicians are equipped with better knowledge of the endocrine and metabolic complications of fungal infections and antifungal therapy, they can more readily recognize them and favorably affect outcome.
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PMID:Endocrine and metabolic manifestations of invasive fungal infections and systemic antifungal treatment. 1877 5

A 15-month-old, female mongrel dog was presented with a 6-week history of inappetence, weight loss, and tetraparesis. Physical examination revealed weakness, poor body condition, mild fever, pale mucous membranes, and diffuse muscle atrophy. The right hind limb was painful and edematous, with large ecchymoses. The femur was irregular on palpation and moderate popliteal lymphadenopathy was evident. Results of a CBC showed severe anemia with mild regeneration, an inflammatory leukogram with 90% of neutrophils parasitized by Hepatozoon sp. gamonts, and moderate thrombocytopenia. A bone marrow aspirate had myeloid hyperplasia and contained a few extracellular Hepatozoon meronts and a few intracellular gamonts within neutrophils. Serum chemistry abnormalities included hypoalbuminemia, hyperglobulinemia, hypoglycemia, hypercalcemia, hyperphosphatemia, and elevated alkaline phosphatase activity. Radiologic findings of the right femur included periosteal bone proliferation and lesions compatible with osteomyelitis. A fine needle aspirate specimen from the bone lesion had neutrophilic inflammation; 36% of the neutrophils contained Hepatozoon gamonts. Results of cerebrospinal fluid analysis included a protein concentration of 37 mg/dL and marked mononuclear pleocytosis (243 cell/microL) with a predominance of lymphocytes. An ELISA was positive for Hepatozoon canis and PCR results with DNA sequencing confirmed infection with this organism. A diagnosis of hepatozoonosis with skeletal involvement and meningoencephalomyelitis was made. The dog recovered almost completely neurologically and had no gamonts in the blood after 60 days of therapy with imidocarb dipropionate and prednisone. This is an unusual case of canine hepatozoonosis involving neurologic signs and a periosteal reaction more typical of H. americanum infection and rarely reported in dogs infected with H. canis.
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PMID:Hepatozoonosis in a dog with skeletal involvement and meningoencephalomyelitis. 1922 65

The etiology of acute confusional state in elderly patients with type 2 diabetes mellitus is broad, including hypoglycemia or hyperglycemia, electrolyte imbalance as hyponatremia or hypercalcemia, cerebrovascular disease and drug intoxication among others. Herein, we present an 80-year-old female type 2 diabetic patient in an acute confusional state due to non-convulsive status epilepticus (NCSE). Timely electroencephalogram at an emergency department when available is the only tool for the diagnosis of NCSE when clinically suspected. All clinicians must consider the possibility of NCSE in the differential diagnosis of acute confusional patients when diagnosis is uncertain.
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PMID:Acute confusional state in type 2 diabetic patient: non-convulsive status epilepticus. 1926 Sep 85

A thorough working knowledge of the diagnosis and treatment of life-threatening electrolyte abnormalities in cancer patients, especially hyponatremia, hypoglycemia, and hypercalcemia, is essential to the successful practice of emergency medicine. Although most minor abnormalities have no specific treatment, severe clinical manifestations of several notable electrolytes occur with significant frequency in the setting of malignancy. The treatment of life-threatening electrolyte abnormalities is reviewed here. Promising future treatments directed at the underlying physiology are also introduced.
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PMID:Electrolyte complications of malignancy. 2048 53

Systemic manifestations of monoclonal gammopathies (MG) are rare but extremely varied. This general review focuses on the hyperviscosity syndrome, neurological disorders, skin changes, the POEMS syndrome, and biological manifestations, with the exception of amyloidosis AL and cryoglobulinemia. The hyperviscosity syndrome usually involves a combination of general, hemorrhagic, ocular and central neurological disorders. The principal neurological manifestations are peripheral neuropathies, mainly due to IgM with anti-MAG activity. Skin disorders include overload dermatoses (xanthomatosis, mucinosis), neutrophilic dermatosis, urticaria, edema and the AESOP syndrome. The POEMS syndrome classically consists of polyneuropathy, organomegaly, endocrinopathy, monoclonal plasmocyte proliferation, and cutaneous manifestations. MG interference with assay methods can lead to false hyponatremia, hypoglycemia, hyperbilirubinemia, hypercalcemia and hypertransferrinemia. These systemic manifestations can reveal classical MG-related disorders such as monoclonal gammopathy of undetermined significance (MGUS), solitary plasmocytoma, multiple myeloma, and Waldenstrom's disease. They are due either to the chemicophysical properties of the monoclonal immunoglobulin, or to its antibody activity (especially against autoantigens), with potential therapeutic implications.
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PMID:Systemic manifestations of monoclonal gammopathy. 1971 43

The Cases of xylitol poisoning in dogs are increasing as a result of ingestion of xylitol-containing products. Eighteen adult, clinically normal Pekingese dogs were orally dosed with 1 or 4 g/kg xylitol in aqueous solution. Blood samples were collected before and after dosing. Plasma insulin concentrations of both treated groups rose sharply from 20 min after xylitol dosing, peaking at 40 min. Hypoglycemia followed the increase in insulin concentration, with blood glucose values started to decrease 30 min after dosing. Other plasma biochemistry changes associated with xylitol administration were increased alanine aminotransferase and aspartate aminotransferase activities, hypophosphatemia, hypokalemia, and hypercalcemia. Plasma sodium and chloride concentrations remained normal. This study established a biochemical basis for diagnosis and treatment of xylitol poisoning in dogs.
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PMID:Experimental acute toxicity of xylitol in dogs. 1975 13

A thorough working knowledge of the diagnosis and treatment of life-threatening electrolyte abnormalities in cancer patients, especially hyponatremia, hypoglycemia, and hypercalcemia, is essential to the successful practice of emergency medicine. Although most minor abnormalities have no specific treatment, severe clinical manifestations of several notable electrolytes occur with significant frequency in the setting of malignancy. The treatment of life-threatening electrolyte abnormalities is reviewed here. Promising future treatments directed at the underlying physiology are also introduced.
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PMID:Electrolyte complications of malignancy. 1944 10

Early stage hepatocellular carcinoma is a symptom-free disease. Local and general symptoms occur due to the growth of the tumor tissue and the infiltration of the surrounding blood vessels. Illness progression is indicated by the development of abdominal discomfort, cachexia, therapy-resistant decompensation of previously compensated cirrhosis and in severe cases, the thrombosis of the portal vein or the hepatic veins. Characteristic laboratory findings are the quickly deteriorating blood and liver function tests results, the occurrence of haemostatic disorders and occasional hypoglycemia and/or hypercalcemia. To clarify the etiology and to identify high risk patients, we need to differentiate alcohol-, drug- or chemical-induced hepatic disorders, viral hepatitis B, C and Delta, metabolic disorders and non-alcoholic steatohepatitis. In the case of focal hepatic lesions, persistently elevated alfa fetoprotein levels have a high diagnostic value. At levels over 200 ng/ml, the positive predictive value is >90%. Other, less commonly measured biomarkers are the glycosilated alfa fetoprotein-L3 and the vitamin K-deficiency induced des-gamma-carboxy prothrombin. The risk of tumor occurrence is multiple in patients with HbeAg positive chronic hepatitis B if the virus is of genotype C with mutations in the 1762 and 1764 locations of the core promoter region. Abdominal ultrasound and measurement of alfa fetoprotein is recommended every 6 months for high risk individuals, or every 3-4 months over an 18-24 months period for patients with hepatic lesions of <1cm and of unknown malignancy.
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PMID:[Symptoms of hepatocellular carcinoma. Laboratory tests used for its diagnosis and screening]. 2071 15

Patients with hepatocellular carcinoma may manifest paraneoplastic syndromes such as hypercholesterolaemia, hypoglycaemia, hypercalcaemia and erythrocytosis. An exceptional case of hepatocellular carcinoma associated with polymyositis, a rheumatic paraneoplastic syndrome, is reported. A 72-year-old male complained for a recent muscular weakness mainly in the proximal limb muscles. The clinical course, a raised level of serum creatine kinase and electromyographic findings suggested polymyositis, and the pathological findings on muscle biopsy were compatible with this diagnosis. Computed tomography of the upper abdomen revealed a mass lesion in segment IV, V and VII of the liver, and alpha foetoprotein level was high, resulting in the diagnosis of hepatocellular carcinoma.
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PMID:Hepatocellular carcinoma with polymyositis as an initial symptom: a case report. 2148 65

Although veterinary clinicians commonly rely on panels of laboratory tests with individual results flagged when abnormal, care should be taken in interpreting normal test results as well. There are several examples of this in evaluating patients with endocrine disease. The finding of a normal leukogram (absence of a stress leukogram) can be indicative of adrenal insufficiency in dogs, and this disorder can be especially elusive when there are no overt indicators of mineralocorticoid deficiency. Cats with hyperthyroidism can have normal serum thyroid hormone concentrations, normal hematocrits, and normal serum concentrations of creatinine despite the presence of disease that affects these parameters. A normal serum phosphorus concentration, in the face of azotemia, isosthenuria, and hypertension can point a clinician toward a diagnosis of primary hyperaldosteronism rather than primary renal disease. A normal serum parathyroid hormone concentration in the face of hypercalcemia is inappropriate and can indicate the presence of primary hyperparathyroidism. Similarly, hypoglycemia accompanied by a normal serum insulin concentration can be found in cases of hyperinsulinism. These normal findings in abnormal patients, and their mechanisms, are reviewed.
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PMID:When normal is abnormal: keys to laboratory diagnosis of hidden endocrine disease. 2159 44


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