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)

Six patients (4 women, 2 men) with malignant gastrinoma developed multiple bone metastases; osteolytic as well as osteoblastic lesions occurred. All lesions involved the central skeleton, most caused symptoms, and, in 2 cases, there was associated hypercalcemia with normal serum parathormone levels. Poor responses were observed after treatment with cytotoxic drugs, but good symptomatic responses occurred after radiotherapy in 2 of the 4 patients in whom it was used. The peptic ulcer component of the disease was well controlled in all patients by cimetidine with or without anticholinergic supplements or by ranitidine alone in doses of 300-600 mg daily. Five of the 6 patients died with a mean survival after diagnosis of Zollinger-Ellison syndrome of 3.3 yr (range 1.0-7.0 yr), suggesting that bone metastases are associated with a poor prognosis in metastatic gastrinoma.
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PMID:Bone metastases in malignant gastrinoma. 375 10

Bone metastases are a major source of morbidity in patients with cancer. Previously, we found that gallium nitrate was a highly effective treatment for cancer-related hypercalcemia. Laboratory studies have shown that this drug inhibits bone resorption in vitro and that short-term treatment in vivo increases the calcium content of bone. We evaluated the clinical effects of gallium nitrate on biochemical parameters of increased bone turnover in 22 patients with bone metastases. Treatment with gallium nitrate for five to seven days caused a median reduction in 24-hour urinary calcium excretion of 66% relative to baseline measurements (P less than .01). Hydroxyproline (OHP) excretion was also significantly reduced (P less than .01). The greatest reduction in hydroxyprolinuria occurred in patients with high baseline excretion. Ionized serum calcium and serum phosphorous declined significantly after treatment (P less than .01 for each). Serum immunoreactive parathyroid hormone (PTH) increased significantly (P less than .01), as did serum levels of 1,25 (OH)2-vitamin D3 (P less than .05). Urinary phosphorous excretion and serum levels of 25-OH-vitamin D3 were not significantly changed. No major toxic reactions occurred as a result of this treatment. These results indicate that gallium nitrate significantly reduces biochemical parameters associated with accelerated bone turnover and that this agent may be useful for preventing pathologic conditions associated with bone metastases.
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PMID:Gallium nitrate inhibits accelerated bone turnover in patients with bone metastases. 380 70

Hypercalcemia developed in a man with recurrent adenocarcinoma of the prostate. Serum calcium became normal soon after bilateral orchiectomy and the patient was free of disease 18 months later. The absence of radiographically detectable bone metastases in this patient suggested a humoral mechanism for the hypercalcemia. Orchiectomy may be an effective treatment for hypercalcemia complicating prostatic carcinoma.
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PMID:Hypercalcemia in carcinoma of the prostate: case report and review of the literature. 380 28

A hypercalcemia frequency of 1.5% was found in patients with malignant disease attending a large oncological center. Eighty per cent of hypercalcemias were of obvious malignant etiology. Hypercalcemia was most frequent in multiple myeloma, renal carcinoma, squamocellular carcinomas of different sites and breast cancer. Most patients had advanced metastasized disease. In 80% of those with solid tumors malignant hypercalcemia was associated with bone metastases. Serum calcium could almost invariably be reduced by treatment, and active treatment was associated with a more favorable prognosis. One year actuarial survival of patients with malignant hypercalcemia was 31%.
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PMID:Malignant hypercalcemia--a hospital survey. 381 29

All patients with carcinoma of the breast seen in this Unit since 1970 were reviewed to study the incidence, prognosis, morbidity and response to treatment of bone metastases. The biological characteristics of the primary tumour were compared in patients relapsing first in bone or liver. Sixty-nine percent of patients dying with breast cancer had bone metastases and bone was the commonest site of first distant relapse. Bone relapse was more common in receptor positive or well differentiated (grade 1) tumours. The median survival was 24 months in those with disease apparently confined to the skeleton compared with 3 months after first relapse in liver. Ten percent of patients with breast cancer developed hypercalcaemia. All had metastatic disease and 85% had widespread skeletal involvement. Fifteen percent of patients with disease confined to the skeleton developed hypercalcaemia. The response in bone to primary endocrine therapy, and chemotherapy, was apparently less than the overall response achieved. A large proportion had apparently static disease reflecting the insensitivity of the UICC assessment criteria. The duration of survival in these patients was similar to responding patients, suggesting a tumour response may occur in the absence of discernable radiological evidence of healing.
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PMID:The clinical course of bone metastases from breast cancer. 381 76

Serum calcium (s-Ca) was measured in 245 patients with bronchial carcinoma. Mean s-Ca (+/- SD) was 2.52 +/- 0.14 mmol/l in the cancer patients, compared to 2.48 +/- 0.14 mmol/l in a control group (p less than 0.01). Sixty-one (25%) of the patients with bronchial carcinoma had hypercalcaemia (s-Ca greater than or equal to 2.60 mmol/l), compared to 16% of the controls. Squamous cell carcinoma was the histological type most often associated with hypercalcaemia. Patients with hypercalcaemia were not overrepresented among those with bone metastases. During follow-up another 32 patients developed hypercalcaemia. Altogether 93 patients (38%) became hypercalcaemic at some time in the course of the disease. In 20 patients s-Ca fell below 2.60 mmol/l after radiotherapy, after operation, or spontaneously. The survival time was significantly shorter for patients with s-Ca above 2.68 mmol/l on admission than for those with s-Ca below this value.
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PMID:Serum calcium in bronchial carcinoma: a population-based study. 381 68

Patients with advanced breast cancer may develop acute, severe hypercalcemia when treated with estrogens or antiestrogens. In this study, we examined the effects of estrogens and related compounds on the release of bone resorbing activity by cultured human breast cancer cells in vitro. We found that the estrogen receptor positive breast cancer cell line MCF-7 releases bone resorbing activity in response to low concentrations of 17 beta-estradiol. Bone resorbing activity was also released in response to the antiestrogen nafoxidine. Other steroidal compounds had no effect on the release of bone resorbing activity. Estrogen-stimulated release of bone resorbing activity occurred with live bone cultures, but not with devitalized bones, indicating that the effect was bone cell mediated. The breast cancer cell line MDA-231, which does not have estrogen receptors, did not release bone resorbing activity in response to 17 beta-estradiol or nafoxidine. Release of the bone resorbing activity by MCF-7 cells incubated with 17 beta-estradiol was inhibited by indomethacin (10 microM) and flufenamic acid (50 microM), two structurally unrelated compounds that inhibit prostaglandin synthesis. Concentrations of 17 beta-estradiol and nafoxidine that caused increased release of bone resorbing activity by the breast cancer cells caused a four- to fivefold increase in release of prostaglandins of the E series by MCF-7 cells. These data may explain why some patients with advanced breast cancer develop acute hypercalcemia when treated with estrogens or antiestrogens, and why bone metastases are more common in patients with estrogen receptor positive tumors.
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PMID:Estrogens and antiestrogens stimulate release of bone resorbing activity by cultured human breast cancer cells. 385 65

Histologic sections of squamous cell carcinomas of four hypercalcemic patients were investigated for the presence of parathyroid hormone (PTH)-like substance. None of the patients had clinical or radiographic evidence of bone metastases. The Sternberger-peroxidase-antiperoxidase-immunoperoxidase technique utilizing monospecific antibody to whole (1 to 84) bovine PTH demonstrated immunoreactive material in all cases. Electron microscopy of the four tumors revealed dense-core secretory granules resembling those seen in parathyroid chief-cell adenomas. The patients did not have elevated serologic levels of PTH or evidence of bone metastases; however, in two cases, osteoclastic bone resorption was seen in bone marrow biopsy specimens. All patients became normocalcemic after definitive tumor resection. The hypercalcemia associated with some nonmetastatic squamous cell carcinomas is associated with the production of PTH-like substance.
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PMID:Localization of parathyroid hormone-like substance in squamous cell carcinomas. An immunoperoxidase study with ultrastructural correlation. 389 84

We reviewed 4 patients with urothelial bladder cancer and hypercalcemia but without evidence of bony metastasis. Of the patients 2 presented with a leukemoid reaction (1 also had thrombocytosis). None of the patients had evidence of bone metastases or other causes of hypercalcemia, such as hyperparathyroidism, sarcoidosis or vitamin D intoxication. All 4 patients received aggressive therapy for the tumors. In each instance the serum calcium returned to normal following radiation therapy or tumor removal, lending support to the theory of humoral hypercalcemia of cancer. A diagnostic and therapeutic approach to such patients is outlined.
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PMID:Nonmetastatic bladder cancer associated with hypercalcemia, thrombocytosis and leukemoid reaction. 394 66

Gallium nitrate was recently found to be effective treatment for resistant cancer-related hypercalcemia. In vitro and in vivo experiments have suggested that the drug directly inhibits calcium resorption from bone; however, the overall effects of gallium nitrate on calcium balance were unknown. We have completed metabolic balance studies in four patients who received this drug by prolonged infusion. All patients were in positive calcium balance while receiving the drug. Each patient also showed a substantial decrease in urinary calcium excretion. Serum phosphorus decreased in all four patients. There was no change in phosphorus, sodium, chloride, or magnesium balance or in creatinine clearance. We conclude that prolonged infusions of gallium nitrate reduce urinary calcium excretion and that the hypocalcemic effect of this drug is primarily due to inhibition of calcium resorption from bone. Thus, the drug may prove useful in reducing accelerated bone resorption in patients with bone metastases or chronic cancer-related hypercalcemia.
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PMID:Metabolic effects of gallium nitrate administered by prolonged infusion. 401 69


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