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)

During a period of 4-7 days, synthetic 1 alpha-hydroxyvitamin D3 (1alpha-OH-D3) was given to osteoporotic patients with hip fractures in 3 different dose levels, viz. 1 microgram, 2 microgram, and 4 microgram, in combination with calcium. The increase in serum calcium level was more prominent during treatment with 2 microgram and 4 microgram doses of 1 alpha-OH-D3 and was also dependent on the duration of treatment. The level of serum phosphate was only slightly elevated. The urinary calcium excretion increased, while the urine phosphate and hydroxyproline excretion decreased. The intestinal absorption of calcium increased in rate during treatment with 1 alpha-OH-D3. On discontinuation of treatment, values did not normalize within 6 days. The administration of small doses of 1 alpha-OH-D3 did not seem to expose osteoporotic patients to the risks of hypercalcemia. The efficiency of vitamin D metabolites in the treatment of osteoporosis requires further investigation.
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PMID:Short-term effects of varying doses of 1 alpha-hydroxyvitamin D3 on blood and urine chemistry and calcium absorption of osteoporotic patients. 70 35

Fifteen patients, 13 women and 2 men (mean age 60 years) with osteoporosis of different types have been under treatment with 1 alpha-hydroxyvitamin D3 and calcium. The responses were observed clinically and by the use of roentgen morphometry, photon absorptiometry and by blood and urine chemical analyses. The treatment had beneficial clinical effect in all but 3 patients. The intestinal calcium absorption rate increased significantly. Slight hypercalcemia and a significant hypercalciuria occurred during treatment. Serum and urine phosphate levels, alkaline phosphatase and parathyroid hormone values were within normal ranges. The bone mineral content increased significantly during treatment. 1 alpha-hydroxyvitamin D3 and calcium was well tolerated by the patients. Three patients had coincidental acute attacks of spinal pain and 2 had further vertebral crush fractures. A period of time longer than one year is necessary to further evaluate the effects of 1 alpha-hydroxyvitamin D3 therapy on the clinical course of severe osteoporosis.
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PMID:Interim report on treatment of osteoporotic patients with 1 alpha-hydroxyvitamin D3 and calcium. 70 36

A sensitive and simplified radioreceptor assay for 1, 25-dihydroxyvitamin D (1, 25-(OH)2D) in human plasma was described and applied to preliminary clinical studies. Tritium-labeled 1, 25-(OH)2D3 was produced by incubating chick kidney homogenate with tritium labeled 25-hydroxyvitamin D3 (25-OHD3). A cytosol receptor was obtained from rachitic chick intestine (Kd=5.3 X 10(-11) M). Lipids in 5 ml of heparinized human plasma were extracted with dichloromethane, and 1, 25-(OH)2D was isolated by a Sephadex LH-20 column followed by high pressure liquid column chromatography. Recovery of 1, 25-(OH)2D3 after the plasma extraction and chromatography ranged from 58 to 100%. The assay was sensitive to 5 pg/tube. Diluted plasma from a patient on a high dose of 1 alpha-OHD3 showed a dilution curve parallel to the standard curve. The cytosol receptor showed a cross reactivity to various vitamin D3 metabolites physiologically present in the circulation and it was thought to be essential to eliminate other vitamin D3 metabolites 1,25-(OH)2D from plasma samples by high pressure liquid chromatography. Plasma concentrations of 1, 25-(OH)2D were, in the case of most normal subjects, distributed from 7 to 33 pg/ml and the range of distribution became greater in relation to age, indicating that plasma values should be matched to age. Whereas markedly high values of 1, 25-(OH)2D in plasma were found in some cases of primary hyperparathyroidism with prominent bone resorption, relatively low values were seen in some patients with chronic renal failure, senile osteoporosis, osteomalacia and hypercalcemia due to bone metastasis.
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PMID:Competitive protein binding assay for 1,25-dihydroxy-vitamin D in human plasma. 74 68

The rate of reversal of hypercalcaemia or hypercalciuria induced by calciferol, dihydrotachysterol, 1-alpha-hydroxycholecalciferol (1-alpha-OHD3), or 1-alpha, 25-dihydroxycholecalciferol (1-alpha, 25-(OH)2D3) was measured in three normal subjects, two patients with osteoporosis, and 14 patients with disorders resistant to vitamin D. The half time for reversal after stopping 1-alpha, 25 (OH)2D3 was less than that after stopping 1-alpha-OHD3, calciferol, or dihydrotachysterol. The differences observed were independent of the dose given or length of treatment. When 1-alpha-OHD3 or 1-alpha-25-(OH)2D3 was stopped patients with vitamin D resistant states (hypoparathyroidism, renal tubular hypophosphataemia, or chronic renal failure) showed less rapid reversal of hypercalcaemia and hypercalciuria than did normal subjects. These studies show one potential advantage of 1-alpha-25-(OH)2D3 over vitamin D, and possibly over 1-alpha-OHD3, in the management of vitamin D resistant states.
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PMID:Rate of reversal of hypercalcaemia and hypercalciuria induced by vitamin D and its 1alpha-hydroxylated derivatives. 83 19

Synthetic 1alpha-hydroxycholecalciferol, a potent vitamin D analogue, was given daily together with calcium to seven patients with senile osteoporosis and to three patients with prednisone-induced bone loss. Quantitative bone histology indicated increased formation and mineralization after three months of treatment. The bone resorption was reduced, a finding supported by a decrease in the urinary hydroxyproline excretion. Photon absorptiometry of the forearm showed a significant rise in the bone mineral content, in accordance with the histological findings. Serum calcium rose in all patients and severe hypercalcemia developed in one case. Urinary excretion of calcium and magnesium increased significantly. The findings indicate that treatment with 1alpha-hydroxycholecalciferol may be useful in osteoporosis due to aging or following corticosteroid administration. The patients must be carefully followed up because of the risk of hypercalcemia.
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PMID:Effect of 1alpha-hydroxycholecalciferol in senile osteoporosis and in bone loss following prednisone treatment. 85 74

Between 1969 and April 1975 24 patients with severe secondary hyperparathyroidism (sHPT) clinically presenting with uremic osteopathy required either total (n=5) or subtotal (n=18) parathyroidectomies, 17 patients were already supported by maintenance hemodialysis, 6 patients suffered from terminal renal insufficiency. The leading clinical symptoms consisted of general osteoporosis, spontaneous fractures, extraosseous calcifications and histologically proven dissecting fibroosteoclasia. After operation 18 patients experienced complete relief from their complaints and repair of their skeletal lesions, 2 patients required reexploration for an undetected hyperfunctioning 4th parathyroid gland, regretfully with no success. In 4 patients with subtotal parathyoidectomy a recurrence of varying intensity with increased PTH-secretion from the remnant had to be registered after months and years.-The indication for surgical treatment of sHPT due to chronic renal failure has to be based on two sets of findings: 1) inadequate longterm suppression of increased PTH secretion by conservative measures like high dialysate calcium concentration or oral calcium intake, serum phosphorus depletion by oral intake of aluminium hydroxyde and possibly also by Vit. D; 2) persistent hypercalcemia, progressive osteodystrophy and severe complaints like bone pain and pruritus.
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PMID:[Surgical aspects of secondary hyperparathyroidism (author's transl)]. 101 8

Osteodystrophy is almost universally present in chronic renal failure. Mild, but detectable, abnormalities--especially in parathyroid hormone (PTH) secretion--occur even when the glomerular filtration rate is greater than 30 cc/min. Osteomalacia is common in areas in which vitamin D intake and exposure to sunlight are minimal; when these factors are plentiful, osteitis fibrosa predominates. Osteoporosis is seen with increasing frequency in hemodialyzed patients. Nonosseous complications of secondary hyper-parathyroidism include hypercalcemia, metastatic calcification and pruritus. The most important factor in the medical therapy of osteodystrophy is control of serum phosphate levels. Next, a positive calcium balance must be provided either by giving vitamin D as dihyrdotachysterol, raising dialysate calcium or administering calcium orally. Parathyroidectomy is sometimes indicated, especially when the patients are transplant candidates and manifest hypercalcemia. Whether or not transplant is contemplated, patients with persistently high calcium-phosphate products, severe metastatic calcification or rapidly progressive osteodystrophy should be considered for parathyroidectomy. Newer, experimental vitamin D preparations, such as 1,25-dihydroxycholecalciferol or 1-alpha-hydroxycholecalciferol, should improve the managemet of patients with renal osteodystrophy and decrease the need for parathyroidectomies.
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PMID:Calcium metabolism in renal failure. 109 Jan 50

The introduction of multiphasic screening and the development of sensitive parathormone assays have changed the demography and clinical symptomatology of patients presenting with primary hyperparathyroidism. This retrospective review includes 158 patients operated on for primary hyperparathyroidism at the Medical College of Georgia from 1973-1987. Compared to the 46 patients managed prior to 1973, the frequency of subclinical hyperparathyroidism has increased from 46% to 64%. The median patient age has increased from 50 to 59 years. Recognition of primary hyperparathyroidism in a more geriatric population modifies indications for surgical intervention in subclinical disease. Osteoporosis, myalgias, fatigue, arthralgias, memory loss, or constipation occurred in 50% of patients. These complaints are frequent in normocalcemic elderly people. They represent disease, not normal aging. Their exacerbation by hypercalcemia should not go uncorrected if neck exploration can be tolerated by the patient.
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PMID:The changing face of primary hyperparathyroidism. 143 43

This report deals with an unusual case of primary macroglobulinemia with hypercalcemia, chronic renal failure and systemic amyloidosis. In May 1990, a 63-year-old male was transferred to our hospital because of hypercalcemia (13.5 mg/dl) and renal failure. Clinical examinations showed anemia, macroglossia, lymph node swellings and hepatomegaly. Laboratory findings included Bence-Jones (kappa type) proteinuria (0.8 g/day), a monoclonal gammopathy of the IgM-kappa type (2.8 g/dl), a proliferation of lymphoid cells in the peripheral blood (5%) and the bone marrow (59.6%), and lymphomatous involvement of an inguinal lymph node. Serum creatinine concentration was 8.5 mg/dl. The serum levels of parathormone and vitamin D3 metabolites were normal. The roentgenogram of bones showed a compression fracture of the lumbar spine and systemic osteoporosis. The treatment included eel calcitonin, prednisolone and the CHOP regimen, followed by hemodialysis and plasmapheresis. The serum level of IgM increased to 4.6 g/dl. The patient died three months later and postmortem examination demonstrated marked systemic amyloidosis.
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PMID:[Primary macroglobulinemia with hypercalcemia, renal failure and systemic amyloidosis]. 146 88

A 37-year-old female with hypercalcemia presented with lumbago, nausea and vomiting. Peripheral blood (PB) and bone marrow (BM) smears revealed no lymphoblasts on the first admission. The value of parathyroid hormone related protein (PTHrP) was increased and osteoporosis was found in the lumbar vertebrae. After 5 months, diagnosis of acute lymphocytic leukemia (ALL) was made on the evidence that lymphoblasts were found in PB (1%) and in BM (98%). Treatment with vincristine, daunorubicin, prednisolone and L-asparaginase achieved complete remission (CR) and the serum calcium level returned to the normal range. She has maintained CR, and is currently treated with consolidation therapy by cyclophosphamide and methotrexate. Acute leukemia is known to be rarely accompanied with hypercalcemia. This rare case was accompanied with hypercalcemia in acute leukemia. Hypercalcemia appeared to be attributable to the increased bone absorption by PTHrP derived from tumor cells. This important case will help understanding the etiology of hypercalcemia associated with ALL.
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PMID:[Acute lymphocytic leukemia (L1) preceded by hypercalcemia]. 160 17


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