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

The risk of tuberculous patients to develop hypercalcemia was investigated in 33 patients aged 19 to 80. Twenty-two of the 33 received no vitamin D supplements. Before antituberculous chemotherapy serum calcium corrected for albumin and urinary calcium levels were normal, serum 25-hydroxyvitamin D (25(OH)D) levels were low, but serum 1,25(OH)2D levels, oral calcium load test and intestinal 47Ca absorption were normal. After 17 to 34 days of chemotherapy serum calcium corrected for albumin and 1,25(OH)2D levels were lower without change in serum D-binding protein. In 11 patients 25(OH)D, 50 micrograms/day, was given orally for two months. 25(OH)D given three days before chemotherapy in five patients induced an increase of levels of 1,25(OH)2D which was greater than in 10 control patients with similar serum levels of 25(OH)D. When chemotherapy was added to 25(OH)D, the five patients showed high normal 1,25(OH)2D levels. The last six patients received 25(OH)D together with or after starting chemotherapy. None of the 33 patients developed hypercalcemia, even when supplemented with 25(OH)D for two months. It appears that hypercalcemia is uncommon in tuberculosis.
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PMID:Are tuberculous patients at a great risk from hypercalcemia? 327 34

Following rehydration with intravenous saline, 27 patients with hypercalcemia of malignancy were treated with a total of 32 courses of 3-amino-1-hydroxypropylidene-1, 1-bisphosphonate (APD) given by slow intravenous infusion. Twelve treatments consisted of daily infusions of APD for between two and six days whereas single-dose APD was used in 20 treatments. Mean albumin-adjusted serum calcium fell to the upper end of the reference range at seven days from the start of treatment, both in multiple-dose and in single-dose treatment groups. No relationship between total dose of APD and hypocalcemic response was observed. However, second treatments with APD following recurrence of hypercalcemia in five patients were significantly less effective than the original therapy, suggesting that resistance to APD may develop. Multiple-dose and single-dose intravenous APD treatments appear to be equally effective in the acute management of hypercalcemia of malignancy.
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PMID:A comparison of single and multiple intravenous infusions of 3-amino-1-hydroxypropylidene-1, 1-bisphosphonate (APD) in the treatment of hypercalcemia of malignancy. 343 16

The theoretical tubular maximum for calcium reabsorption was calculated and its usefulness assessed in the diagnosis and differential diagnosis of primary hyperparathyroidism and familial hypocalciuric hypercalcaemia. The sensitivity of the test in the diagnosis of primary hyperparathyroidism was only 12%. The theoretical tubular maximum for calcium reabsorption was recalculated after correction of calcium concentration in plasma for albumin concentration and for urinary sodium excretion. Despite these corrections, the sensitivity improved to only 44%. This contrasts with a sensitivity of 80% for the plot of fasting calcium excretion against calcium concentration in plasma in primary hyperparathyroidism. The calculation of theoretical tubular maximum for calcium reabsorption cannot be recommended as a useful test for distinguishing between primary hyperparathyroidism and familial hypocalciuric hypercalcaemia. The simple calculation of fractional excretion of calcium was a better test in distinguishing familial hypocalciuric hypercalcaemia from primary hyperparathyroidism.
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PMID:Tubular maximum for calcium reabsorption: lack of diagnostic usefulness in primary hyperparathyroidism and familial hypocalciuric hypercalcaemia. 362 96

In 93 children, end-stage renal disease was treated with the new dialytic methods of continuous ambulatory peritoneal dialysis (CAPD) or continuous cycling peritoneal dialysis (CCPD) over 5 years. Modality survival rates at 36 months with CAPD, CCPD, or both were 20%, 93%, and 87%, respectively. Use of CCPD as the primary dilaytic method increased during the study period. The peritonitis rate was one episode per 11.8 patient treatment months and was similar with both CAPD and CCPD. Gram-positive organisms were cultured in 34% of these episodes of peritonitis. Staphylococcus aureus peritonitis was associated with a recurrence rate of 40% and led to catheter replacement in 45% of the episodes. Peritoneal membrane failure necessitating switching to hemodialysis was related to peritonitis in three patients. Of the 74 peritoneal catheters that required replacement, 70% were infected. Serial serum levels of urea nitrogen, potassium, calcium, phosphorus, albumin, and alkaline phosphatase remained stable, whereas serum creatinine level rose slightly over time. Episodes of hyperkalemia, hypercalcemia, and hyperphosphatemia were observed at a frequency of one episode per 12.2, 4.6, and 2.5 treatment months, respectively. Blood transfusions were required in once per 1.5 and 3.3 treatment months in seven anephric patients and in 35 patients with their own kidneys, respectively (P = 0.05). In prepubertal patients who received CAPD or CCPD for greater than 1 year, little or no improvement in growth occurred in relationship to either chronologic or bone age.
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PMID:Five years' experience with continuous ambulatory or continuous cycling peritoneal dialysis in children. 365 81

Fifty-two patients with active pulmonary tuberculosis were studied. Seventy percent of the patients were hypocalcemic at admission, but became normocalcemic after ten weeks of therapy. The improvement in hypocalcemia was thought to be due to either improved serum protein and albumin levels, which occurred after admission, or the reduced physical activity of the patients.Care should be taken in giving patients with pulmonary tuberculosis vitamin D supplements because of the possibility of hypersensitivity to vitamin D.The possible mechanisms of hypercalcemia in active pulmonary tuberculosis are discussed.
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PMID:Plasma calcium in active pulmonary tuberculosis. 366 92

We studied mineral metabolism in 15 thyrotoxic patients and 15 controls matched for sex, age, and weight. Thyrotoxic subjects showed significantly higher serum calcium, phosphate, alkaline phosphatase, and globulin and lower serum creatinine, magnesium, and albumin. Parathyroid hormone immunoreactivity (iPTH) was measured with three different antisera. Thyrotoxic patients showed markedly reduced iPTH values in the most sensitive assay, a midregion-specific assay based on homologous antiserum BG-6. Antiserum 211/32 gave slightly reduced iPTH values, but antiserum NG-1 gave values that were increased by 65%. The limited sensitivity of these later two antisera, like that of others used earlier for such studies, may have blunted the apparent fall in iPTH (antiserum 211/32) or predisposed the assay to a systematic artifact (antiserum NG-1). These results show that for use in the evaluation of hypercalcemia in thyrotoxic patients, a PTH assay must first be characterized as to the expected result in uncomplicated thyrotoxicosis. Twelve of the thyrotoxic subjects entered a random order cross-over study in which propranolol and placebo were given in double-masked fashion for 6 consecutive days each. Overall, the drug did not alter calcium, phosphate, or magnesium metabolism. It lowered serum calcium only in two overtly hypercalcemic subjects, whose urinary calcium excretion did not decline. These results confirm that propranolol may reduce elevated serum calcium levels in thyrotoxicosis and suggest that in this setting the drug may have a direct or indirect effect on renal calcium metabolism.
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PMID:A controlled study of the effects of thyrotoxicosis and propranolol treatment on mineral metabolism and parathyroid hormone immunoreactivity. 384 May 65

Controversy has arisen regarding the indications for elective surgical intervention in asymptomatic primary hyperparathyroidism (HPT). The present study was designed to answer two questions: Is untreated primary HPT a progressive disease over time? If not, are the risks attendant on long-term conservative management comparable to those obtained from surgery? Forty-seven patients with primary HPT, established by a persistently elevated serum calcium level and an inappropriately elevated parathormone value, who were managed conservatively and followed for a minimum of 5 years were identified. Serial data collection included calcium, phosphorus, albumin, creatinine, alkaline phosphatase, parathormone levels, skeletal x-ray films, and complications known to result from primary HPT. For each patient the collected data were divided into three equal periods of time (minimum of 20 months per period). In addition, the patients were classified into three groups based on their average serum calcium levels during the first observation period. No patient in any of the three groups experienced a significant progressive increase in serum calcium levels during the periods of observation. Sixteen of the 47 untreated patients (34%) experienced a complication usually associated with primary HPT: peptic ulcer disease (eight patients), decrease in renal function (five patients), renal calculus (one patient), hypercalcemic crisis (one patient), and ventricular conduction defect (one patient). Four deaths were attributed to these complications. In conclusion, the course of primary HPT and attendant complicating features are not accompanied by worsening of the hypercalcemia initially observed. None of the parameters studied offered an accurate prediction of likelihood, progression, or severity of complications. The risks associated with long-term nonoperative management of asymptomatic primary HPT are nevertheless considerable and exceed the morbidity and mortality rates resulting from neck exploration.
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PMID:Observations on the course of untreated primary hyperparathyroidism. 387 2

Investigations were carried out with 24 sheep divided into two groups of twelve animals. The first group were infected via the lateral recessus of the tarsal joint with 2 cm3 of a 24-hour broth culture of Corynebacterium pyogenes, and the second one were infected i/v with 3 cm3 of the same culture. The changes in the total protein, protein fractions, and blood electrolites in the blood were followed up. It was found that the infection of Corynebacterium pyogenes affected the total reactivation of the animals and led to immunobiologic reconstruction changes. There were hyperproteinemia which depended on the route of infection as well as the severity of its course, and hyperglobulinemia which was "at the expense of' blood albumin. Noticed were also hypercalcemia, hyperpotassemia, and lower sodium and phosphorus levels.
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PMID:[Biochemical changes in the blood of sheep with experimental Corynebacterium infection]. 388 45

We measured calcium, phosphate, chloride, albumin, C-terminal parathyrin, and beta 2-microglobulin in serum from 102 hypercalcemic patients: 42 with primary hyperparathyroidism and 60 with neoplasia. The calcium concentrations and the discriminant function index of Johnson et al. (Clin Chem 28, 333-338, 1982) were higher in malignant hypercalcemia than in primary hyperparathyroidism. The diagnostic efficiency of the index and of parathyrin concentration was 82% and 78%, respectively. Using the ratio of parathyrin to beta 2-microglobulin increased the diagnostic efficiency to 98%; the ratio of the discriminant index to parathyrin concentration had a diagnostic efficiency of 100%. We conclude that C-terminal assay by itself is no better than the discriminant function index.
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PMID:Value of measuring C-terminal parathyrin in differential diagnosis of hypercalcemia. 390 87

Total serum calcium (Ca), ionic calcium (Ca++), phosphorus, magnesium, total protein, immunoreactive parathyroid hormone (iPTH), calcitonin (iCT) and prolactin (iPRL) were measured in 30 paired samples of cord and maternal blood obtained at term delivery. In the cord blood, the concentrations of Ca, Ca++, phosphorus, magnesium, albumin, iCT and iPRL were all higher, and the concentrations of total protein and iPTH lower than in the maternal blood. The calcium binding capacity of albumin assessed with the equation (Ca-Ca++)/albumin, was similar at a given concentration of Ca in both the maternal and fetal circulations. There was a significant positive correlation between cord Ca++ and maternal Ca or Ca++, and a significant negative correlation between Ca++ and iPRL in cord blood. These data suggest that there is an active system transporting calcium from mother to fetus through the placenta, and PRL is the only one of the three hormones which was correlated with ionic calcium values in the fetus. The negative relationship between Ca++ and iPRL in the cord blood suggests an inhibitory effect of the relative hypercalcemia on PRL secretion in the fetus.
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PMID:The negative correlation between prolactin and ionic calcium in cord blood of full term infants. 401 78


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