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

Paraneoplastic hypercalcemia is frequently observed in squamous cell carcinoma of the bronchus. Clinically, apart from the general symptoms which are always very marked, neurological signs are the most common. This hypercalcemia, accompanied by hypophosphatemia, is of sudden onset and immediately very high. Metabolic alkalosis, with hypokalemia and hypochloremia, differentiates it from true hyperparathyroidism. Symptomatic treatment is only transiently effective. However, the obvious effect of mitramycin may be useful before surgical operation, which alone produces a lasting normalisation of serum calcium. Inappropriate secretion of a parathormone substance by the tumour may be demonstrated by radio-immunoassay, and this explains a large number of cases of hypercalcemia but this does not exclude other possible factors in the etiology. Finally, hypercalcemia originally attributed to bony lysis, may be explained in some cases by a paraneoplastic process.
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PMID:[Paraneoplastic hypercalcemia in primary bronchial cancer]. 18 20

3 cases of hypercalcemia are reported, among 14 tetraplegic patients with porphyria. The calciuria, the estimations of parathormone, calcitonin and the isotopic calcium balance studies, suggested in the two most serious cases, hypercalcemia due to immobilisation. The main factor seems to be the duration of the immobilisation. The predisposing role of renal failure and catecholamines is discussed.
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PMID:[Hypercalcemia during acute intermittent porphyria. Apropos of 3 cases]. 19 80

A particularly high hypercalcemia (141 mg/ml) was observed in a man with Graves' disease. An intense muscle asthenia, with lack of dynamism and vomiting which may cause dehydration, are the most suggestive signs of hypercalcemia. Bone biopsy and above all parathormone estimations permit one to eliminate associated hyperparathyroidism. The efficacy of mithramycin used alone, without any other hypocalcemic drug, was remarkable. The direct responsibility of thyrotoxicosis as a cause of the calcium disorder seems undoubted but the precise mechanism of the hypercalcemia remains unexplained.
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PMID:[Severe hypercalcemia during hyperthyroidism]. 19 81

Metastatic soft tissue calcification is known to occur in hypercalcemia and is usually present in the kidneys, stomach and lungs. 1--3 This case presents two unusual features: 1) ectopic parathormone production in association with poorly differentiated lymphocytic lymphoma; and and 2) uptake of 99mTc-pyrophosphate in the liver in the absence of demonstrable abnormality at autopsy. The more usual sites of metastatic calcification also showed uptake of the radionuclide. We will discuss metastatic soft tissue calcification, ectopic parathyroid hormone production, hypercalcemia in malignancy and bone scan agent localization in soft tissues.
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PMID:Poorly differentiated lymphocytic lymphoma with ectopic parathormone production: visulization of metastatic calcification by bone scan. 21 69

Pancreatitis has been described previously following renal transplantation, but not in association with chronic renal failure. Analysis of 168 patients with renal transplants revealed five who developed pancreatitis, three of whom died. All five were on treatment with prednisone and azathioprine. Four patients were seen with definite attacks of pancreatitis and chronic, stable renal failure from a variety of causes. None had received immunosuppressive agents, prednisone nor thiazide diuretics, but two were on regular frusemide. One patient was on maintenance dialysis, which could not be related directly to the pancreatitis. In either group alcohol ingestion, cholethiathiasis, or hypercalcaemia was not a factor. This diagnosis of pancreatitis was established on clinical grounds and serum amylast levels of greater than 900 iu/1. Similar serum amylast elevation was not found ina random group of patients with chronic renal failure. Hyperlipidaemia was not present in any patient with pancreatitis. Although hypercalcaemia and primary hyperparathyroidism was not found in the transplant and non-transplant subjects, elevated serum parathormone levels have been described in uraemic patients with normocalcaemia. Hyperparathyroidism may be a factor in the development of pancreatitis in reanl failure. Pancreatitis carries a significant mortality risk in renal transplantation. The four non-transplanted patients have survived, despite recurrent attacks of pancreatitis.
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PMID:Pancreatitis and renal disease. 31 21

Hypercalcaemia accompanied a bladder tumour in a 77-year-old woman. Immuno-reactive parathormone (IPTH) in the tumour being high, the hypercalcaemia could thus be attributed to secretion by the tumour of a substance with parathormone activity. The rarity of bladder tumours at the origin of paraneoplastic hypercalcaemia is recalled. The mechanism of the metabolic disturbance and the disagreement between serum and tumour levels of IPTH are discussed.
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PMID:[Paraneoplastic hypercalcaemia in a case of carcinoma of the bladder. Demonstration in the tumour of a substance with parathormone activity (author's transl)]. 48 2

Two cases of paraneoplastic hypercalcemia secondary to ovarian tumors are presented. Both cases were secondary to ectopic parathormone (PTH) production. Other mediators postulated to cause this syndrome are prostaglandins, vitamin D-like sterols, non-vitamin D sterols, vitamin A, cortisol, and "osteoclast-activating factor.' The key treatment modalities for acute hypercalcemia are hydration and diuresis with furosemide; phosphates, steroids, antiprostaglandins, and hemodialysis may also be of value. Calcitonin is theoretically the most attractive treatment modality, but the rapid development of resistance limits its use to acute management. Mithramycin is most effective for long-term palliation of hypercalcemia if tumor-directed therapy is unsuccessful. Review of the literature confirms the previously made observation that mesonephromas are disproportionaately represented in association with this syndrome.
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PMID:Paraneoplastic hypercalcemia in ovarian tumors. 49 33

A patient with primary hyperparathyroidism underwent cervical exploration and hemithyroidectomy. Only one normal parthyroid gland was found and was removed. Hypercalcemia persisted and subsequent arteriography localized a large mediastinal adenoma which was excised. Parathyroid autotransplantation of a small part of this tissue was performed and the patient was well for over a year. He again became markedly hypercalcemic and graft-dependent elevation of parathromone levels was demonstrated. Autograft resection resulted in normocalcemia. Nineteen months later hypercalcemia and elevated parathormone levels prompted re-exploration of the graft site and another enlarged implant was removed. This restored normocalcemia and normal parathromone levels. Parathyroid adenomatous tissue has the potential for autonomous hyperfunction, and caution must be exercised in its use in autotransplantation.
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PMID:Hyperparathyroidism following parathyroid autotransplantation. 49 61

Rapid differential diagnosis of hypercalcaemia due to primary hyperparathyroidism or malignancy with or without bone metastases may be life saving. A parathormone infusion test (6 USP units/kg body wt X 20 min) enables a differential diagnosis within three hours by means of measurement of renal calcium excretion. In normal persons calcium excretion decreased from 147 +/- 90 to 79 +/- 54 mumol/h (x +/- s, n = 10). In primary hyperparathyroidism with hypercalcaemia the high calcium excretion remained unchanged: 716 +/- 162 mumol/h before and 804 +/- 130 mumul/h 120 minutes after the PTH infusion (n = 12). In patients with hypercalcaemia caused by bronchial carcinoma with (n = 5) and without (n = 1) bone metastases calcium excretion decreased from 552 +/- 182 to 163 +/- 114 mumol/h. As a consequence of these data this test is advisable when the indication for operation in cases with hypercalcaemia has to be reached within a few hours.
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PMID:[Differential diagnosis of hypercalcaemia by measurement of renal calcium excretion during parathormone administration (author's transl)]. 49 90

The influence of 5,6-trans-25-hydroxycholecalciferol on renal osteopathy was investigated in a total of 132 patients in 26 dialysis centres. Various doses were used, the average being 4000-6000 IU/day. In 32 patients a daily dose of 6000-9000 IU was used. The average individual duration of treatment was 276 days with a maximum of 910 days. Histologically there was an improvement in the renal osteopathy in 55.9% of evaluable cases (n = 34) and in 25.3% there was no deterioration. Radiographically these results were found in 21% and in 70.5% of evaluable cases (n = 105). Serum calcium increased in 46.6% of cases (n = 131), remained the same in 32.8% and decreased in 20.6%. The changes in alkaline phosphatase were similar : it dropped in 42.1% of patients, remained the same in 28.1% and rose in 29.8%. Immunoreactive parathormone which was invariably raised at the beginning of treatment (n = 36), fell in 25.0%, remained the same in 44.4% and rose further in 30.6%. The clinical symptoms of renal osteopathy which had been present in 57 patients improved in 51.0%, remained the same in 46.0% and deteriorated in 3.0%. Signs of intolerance and side effects were rare. Severe hypercalcaemia did not occur.
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PMID:[Treatment of renal osteopathy with 5,6-trans-25-hydroxycholecalciferol (author's transl)]. 52 Jan 65


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