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

Medical emergencies due to severe hypercalcaemia and hypocalcaemia are relatively rare in clinical practice. 89 cases of hypercalcaemia were seen during 1975-1987 and 16 presented as medical emergencies; renal colic (7) acute renal failure (3), spontaneous fractures (3), acute pancreatitis (1), cardiac arrhythmia (1) and acute hypercalcaemic crisis resulting in death (1). 81 cases of severe hypocalcaemia were seen during the same period. 22 presented initially as epileptic seizures with one ending fatally due to status epilepticus. The other emergencies were severe laryngeal stridor and inability to speak (7), papilloedema (3) and acute behavioural disorder (4). A few illustrative cases have been briefly described.
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PMID:Medical emergencies associated with disorders of calcium homeostasis. 229 66

The schema in Table 1 illustrates the inter-relationship between the major fluid and electrolyte disturbances with their primary site of involvement, that is, the CNS or peripheral nervous system (PNS), their primary effect (nervous system depression or irritability), and the major symptom complex associated with these sites and mechanisms (obtundation, seizures, muscle weakness, and tetany). As can be seen, a pattern emerges. Disorders of sodium and osmolality, whether hypernatremia (hyperNa), hyponatremia (hypoNa), hyperosmolality (hyperOsm), or hypo-osmolality (hypoOsm), all produce CNS depression with encephalopathy as the major clinical manifestation. Disorders of potassium, whether hyperkalemia (hyperK) or hypokalemia (hypoK), produce PNS depression with muscle weakness as the major clinical manifestation. On the other hand, disorders of magnesium and calcemia produce both CNS and PNS manifestations. Hypercalcemia (hyperCa) and hypermagnesemia (hyperMg) produce CNS and PNS depression with encephalopathy and muscle weakness, respectively, being the major clinical manifestations. Hypocalcemia (hypoCa) and hypomagnesemia (hypoMg) produce CNS and PNS irritability with seizures and tetany, respectively, being the major clinical manifestations.
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PMID:Neurologic manifestations of fluid and electrolyte disturbances. 267 34

Immobilization hypercalcemia usually causes mild neurologic symptoms. Seizures are a rare complication, appearing weeks after the appearance of other symptoms of hypercalcemia. We report here the case of a 10-year-old boy who developed generalized seizures early in the course of the syndrome. In this child, early diagnosis and therapy probably prevented the more complicated course described in previous cases. We wish to draw attention to this potentially life-threatening complication of immobilization.
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PMID:Immobilization hypercalcemia: unusual presentation with seizures. 274 1

Extensive mineralization of the aorta, brachiocephalic trunk, and the left subclavian, both iliac, common carotid, and renal arteries were found at necropsy in a 3-year-old French Lop rabbit. The rabbit had been examined previously for seizures, at which time abdominal radiography revealed calcification of the abdominal aorta and external iliac arteries. Treatment was not initiated, and the rabbit died 4 months later of bacterial pneumonia. The rabbit also had hypercalcemia. In contrast to many species, the blood calcium concentrations of rabbits reflect dietary intake.
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PMID:Arteriosclerosis in a rabbit. 292 82

A 48-yr-old man with squamous cell carcinoma of the lung, hypercalcemia, and brain metastases with seizures was treated with phenytoin. Constant nasogastric infusion with Osmolyte was begun for hydration and nutritional status, necessitating an increase in his phenytoin dosage. Adequate seizure control and phenytoin levels were obtained on this adjusted regimen. However, on the 16th hospital day, the patient pulled out his nasogastric tube and received two doses of phenytoin without Osmolyte. The patient became lethargic, and his phenytoin level was 53 micrograms/ml. The patient was placed on bolus nasogastric feedings and a lower dose of phenytoin administered between feedings. Adequate seizure control and appropriate phenytoin levels were obtained with no further problems. The recommended management of the phenytoin-enteral feeding interaction is to flush and clamp the nasogastric tube for 2 hr before and 2 hr after the phenytoin dose.
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PMID:Interaction of oral phenytoin with enteral feedings. 308 93

Magnesium is an important element for health and disease. Magnesium, the second most abundant intracellular cation, has been identified as a cofactor in over 300 enzymatic reactions involving energy metabolism and protein and nucleic acid synthesis. Approximately half of the total magnesium in the body is present in soft tissue, and the other half in bone. Less than 1% of the total body magnesium is present in blood. Nonetheless, the majority of our experimental information comes from determination of magnesium in serum and red blood cells. At present, we have little information about equilibrium among and state of magnesium within body pools. Magnesium is absorbed uniformly from the small intestine and the serum concentration controlled by excretion from the kidney. The clinical laboratory evaluation of magnesium status is primarily limited to the serum magnesium concentration, 24-hour urinary excretion, and percent retention following parenteral magnesium. However, results for these tests do not necessarily correlate with intracellular magnesium. Thus, there is no readily available test to determine intracellular/total body magnesium status. Magnesium deficiency may cause weakness, tremors, seizures, cardiac arrhythmias, hypokalemia, and hypocalcemia. The causes of hypomagnesemia are reduced intake (poor nutrition or IV fluids without magnesium), reduced absorption (chronic diarrhea, malabsorption, or bypass/resection of bowel), redistribution (exchange transfusion or acute pancreatitis), and increased excretion (medication, alcoholism, diabetes mellitus, renal tubular disorders, hypercalcemia, hyperthyroidism, aldosteronism, stress, or excessive lactation). A large segment of the U.S. population may have an inadequate intake of magnesium and may have a chronic latent magnesium deficiency that has been linked to atherosclerosis, myocardial infarction, hypertension, cancer, kidney stones, premenstrual syndrome, and psychiatric disorders. Hypermagnesemia is primarily seen in acute and chronic renal failure, and is treated effectively by dialysis.
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PMID:Magnesium metabolism in health and disease. 328 51

Theophylline, with its narrow therapeutic margin, is a common cause of iatrogenic and deliberate overdose. Most cases of self-poisoning are with sustained release preparations, with peak concentrations occurring up to 12 or more hours after overdose. Toxic symptoms are often seen at concentrations above 15 mg/L. Theophylline is metabolised within the cytochrome P-450 system, with an average total body clearance of 50 to 60 ml/min. Clearance is, however, affected by many factors such as other drugs or disease, and in overdose zero order kinetics may result in prolonged half-lives. Toxicity is characterised by agitation, tremor, nausea, vomiting, abdominal pains, seizures, and tachyarrhythmias. Hypokalaemia and metabolic acidosis are more profound in acute toxicity, and hypercalcaemia is usually present. Seizures occur at lower concentrations after chronic over-medication than after acute overdose. Gastric lavage should be performed in all patients presenting early, and an oral multiple dose charcoal regimen started with 50 to 100g charcoal, repeating with 50g doses and checking theophylline concentrations at 2- to 4-hour intervals. Multiple dose charcoal can be expected to double the clearance of theophylline, being as effective as a haemodialysis. Of the invasive techniques available, charcoal haemoperfusion is the most effective, increasing clearance 4- to 6-fold. Supportive care is particularly important. The aggressive supplementation of potassium, treatment of emesis with droperidol and ranitidine, and treatment of tachyarrhythmias and hypotension (possibly with propranolol), together with oral multiple dose charcoal may obviate the need for haemoperfusion. Seizures suggest increased morbidity and mortality. Charcoal haemoperfusion should be considered if plasma concentrations are greater than 100 mg/L in an acute intoxication or greater than 60 mg/L in a chronic intoxication. The decision to haemoperfuse should not be based on plasma concentrations alone, but an overall evaluation of the patient's laboratory and clinical status.
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PMID:Role of extracorporeal drug removal in acute theophylline poisoning. A review. 330 69

Hypercalcemia caused by primary hyperparathyroidism was believed to be responsible for seizures in a dog. A diagnostic evaluation showed no primary causes of seizures. After surgical excision of the adenomatous parathyroid gland, phenobarbital treatment was discontinued, without recurrence of seizures.
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PMID:Seizures as a manifestation of primary hyperparathyroidism in a dog. 334 85

Two dogs were examined because of anorexia, lethargy, muscle tremors, weakness, and seizures that were associated with an acute onset of hypocalcemia. Both dogs had histories of chronic hypercalcemia. Examination of the parathyroid glands revealed infarction of focal parathyroid adenomas, with atrophy of the remaining parathyroid glands. It was concluded that the acute onset of hypocalcemia was caused by infarction of functional parathyroid adenomas that were previously responsible for the cause of persistent hypercalcemia. Infarction of a parathyroid adenoma should be included in a list of differential diagnoses of acute hypocalcemia in the dog, especially if hypercalcemia has been diagnosed previously.
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PMID:Acute hypocalcemia associated with infarction of parathyroid gland adenomas in two dogs. 335 Jul 46

In 19 chronic alcoholics with rhabdomyolysis the clinical picture demonstrated markedly different degrees of severity of myolysis. Muscle pain, muscle swellings and brown-coloured urine were rare. But symptoms of delirium, at times with cerebral seizures, were frequent at the onset. Renal failure of different degrees was common; five patients had to be dialysed. Two patients died in irreversible shock. Respiratory insufficiency and hypercalcaemia were other complications. Early recognition of the disease is important, because early treatment can prevent acute "myoglobinuric" renal failure.
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PMID:[Rhabdomyolysis as a complication of chronic alcoholism. Observations in 19 cases]. 394 97


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