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

In 44 patients, all suffering from a malignant disease with hypercalcaemia, plasma parathormone was measured by a radioimmunoassay measuring the intact PTH molecule. The results as a function of plasma calcium were compared with those in 38 patients suffering from proven primary hyperparathyroidism and with those in 9 cases of hypercalcaemia of other origin. PTH was indetectable in 14 cases of malignant disease and normal in 25 cases. In 5 patients only could PTH and plasma calcium not be separated from primary hyperparathyroidism. 3 patients had an increased PTH level when plasma calcium was lowered by treatment of the underlying disease. In patients with malignant disease hypercalcaemia is rarely caused by increased secretion of PTH. In these cases either primary hyperparathyroidism or ectopic secretion of PTH may be the cause of hypercalcaemia.
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PMID:[Determination of plasma parathyroid hormone in the differential diagnosis of hypercalcemias associated with malignant tumors]. 66 97

A prospective series of 200 patients with persistent hypercalcemia had an abbreviated diagnostic work-up consisting of parathormone radioimmunoassay, chest roentgenogram, intravenous pyelography, and serum protein electrophoresis. All patients with hypercalcemia and hyperparathormonism had neck exploration if roentgenograms failed to reveal evidence of ectopic hyperparathyroidism. Serum iPTH proved to be at least 96% accurate in predicting parathyroid disease while at the same time resulting in considerable diagnostic economy. An elevated iPTH was particularly helpful in distinguishing between hypercalcemia due to destruction of bone by malignancy and primary hyperparathyroidism with a coexisting malignancy. Further, measurement of parathormone was useful in evaluation of postoperative hypercalcemia.
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PMID:Serum parathormone in the identification and surgical management of hyperparathyroidism. 70 2

Hypercalcemia occurred in 4 dogs with renal failure. Primary causes of hypercalcemia previously described in the dog (primary hyperparathyroidism, pseudohyperparathyroidism, vitamin D toxicosis) were not identified. Increased concentrations of circulating immunoreactive parathormone were found in 2 dogs, and thyroparathyroidectomy of 1 dog resulted in decreased serum concentrations of that hormone as well as of calcium. The latter observations indicated that hypercalcemia was related to increased parathormone activity, but the possibility of other homeostatic imbalances was not excluded. It was concluded that renal failure should be considered as a primary cause of hypercalcemia, along with other causes previously identified.
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PMID:Hypercalcemia secondary to chronic renal failure in the dog: a report of four cases. 72 83

Of 51 patients with primary hyperparathyroidism (2 patients with MEN, Type 1 clinical symptomatology, diagnostic procedures, differential diagnosis, operative strategy and long-term results are being reported. Aside from clinical findings and radiologic signs in our hands determination of the ionized serum calcium fraction, results of chrest bone biopsies and parathormone determinations are best parameters to substantiate the diagnosis of PHPT. Parathormone radioimmunassay determination is very helpful in localizing the adenoma, especially in cases of reoperations. Five patients were seen in acute hypercalcemic crises, in which emergency operations are absolutely indicated. Postoperative hypercalcemia and recurrencies were observed in 3.9%. Successful extirpation of parathyroid adenomas (15% multiple adenomas were found) is the therapy of choice in PHPT, only in cases with hyperplasia subtotal parathyroidectomy is indicated.
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PMID:[Diagnosis and therapy of primary hyperparathyroidism (author's transl)]. 72 76

On the basis of 100 cases of hypercalcemia, the authors attempt to elucidate the criteria of the etiologic diagnosis. Kidney lithiasis or nephrocalcinosis suggested a primary hyperparathyroidism (HPT I) or an intoxication due to vitamin D. X rays of the skeleton and quantitative histological exams of the bone were not useful in the diagnosis of HPT I. The level of parathormone in the plasma is the best parameter to be used in distinguishing HPT I from other diseases. In the absence of renal insufficiency or severe intestinal disorders, a phospharemia below 2.6 mg/100 ml, a chloremia above 103 m EG/l and bicarbonates below 25 m Eg/l indicate an HPT I or a paraneoplasic. A phosphoremia above 3.2 mg/100 ml runs counter to this diagnosis. The chloremia/phosphoremia ratio is not more helpful than the phosphoremia alone.
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PMID:[Etiologic diagnosis of hypercalcemia. A study of 100 cases]. 72 66

Parathormone levels were determined in 17 patients with functioning renal transplants. In 8 patients recently transplanted, very high serum levels of parathormone were found without obvious relation to the glomerular filtration rate. Hypophosphatemia was also present in these cases. In 9 other patients studied 2-7 years after transplantation the mean level of parathormone was lower than in the previous group but levels above normal were noted in half of the patients, some of which had perfect renal function and normal serum phosphorus. The response to induced hypercalcemia was used as a sensitive test to reveal abnormal responses even in cases which initially had normal peripheral levels of parathormone. From these results, tertiary hyperparathyroidism would appear to be rare although hyperfunctioning parathyroid glands can be demonstrated long after kidney transplantation, even when renal function is close to normal.
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PMID:Evolution of secondary hyperparathyroidism after renal transplantation. 77 58

Four patients having high-level quadriplegia developed elevated serum calcium concentrations (11 to 15.8 mg/100 ml) within three months of injury. All were young males (ages 15 to 19 years) and quadriplegic (C4-C7). Presenting symptoms were nausea, vomiting, polydipsia, polyuria and lethargy. In two patients severe muscle wasting and cachexia with clinical symptoms developed and persisted for several months. Laboratory studies in all patients showed negative calcium balance with hypercalciuria. Reduced renal function was seen in all patients but returned to normal with return of normal serum calcium. Alkaline phosphatase level was normal in three and elevated in one. Serum parathormone levels were normal. Roentgenograms revealed diffuse demineralization. Nephrocalcinosis and soft tissue calcifications developed in one patient. Primary treatment included reduced calcium intake, correction of dehydration, sodium infusion and remobilization. Corticosteroids, oral phosphates, furosemide and mithramycin were used with varying success to control prologned symptoms and severe hypercalcemia.
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PMID:Immobilization hypercalcemia in spinal cord injury. 83 59

The use of intravenous procaine in the treatment of hyperpyrexia in a patient with hyperparathyroidism has not been previously reported. A case of metastatic malignant melanoma precipitating the syndrome of hypertonicity of muscle, hyperpyrexia, acidemia, hypercalcemia and elevated serum parathormone levels is presented. Mithramycin was used in an attempt to reduce elevated serum calcium concentrations. The use of intravenous procaine in "caffeine rigor" and malignant hyperthermia due to succinylcholine and halothane formed the basis for its trial in this case. The relationship between cyclic AMP and calcium ions is discussed in postulating mechanism of procaine action.
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PMID:The use of procaine in acquired malignant hyperthermia in a patient with malignant melanoma metastatic to the parathyroid gland: a case report. 99 Sep 78

An example of Kaposi's sarcoma with primary involvement of lymph nodes is reported. The patient, a woman, was admitted because of generalized lymphadenopathy and anemia. She was also known to have congestive heart failure of rheumatic origin. SMA-12 screening disclosed hypercalcemia on several occasions during her hospitalization. Levels of circulating parathormone and prostaglandins E2 and F were markedly increased. Total bone scan was negative for involvement by tumor. Electronmicroscopic examination of an involved lymph node disclosed secretory bodies in the cytoplasm of malignant cells and other cells, with clear indication of endothelial origin. The rarity of Kaposi's sarcoma with primary lymph nodal involvement in the United States is discussed. So far as is known by the authors, no example of Kaposi's sarcoma has been associated with hypercalcemia due to ectopic endocrine production.
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PMID:Primary Kaposi's sarcoma of lymph nods. 99 71

A fifty-three-year-old man with epidermoid carcinoma of the penis metastatic to the right inguinal lymph nodes and adjacent areas was found to have persistent hypercalcemia. Associated with this biochemical abnormality was an elevated parathormone activity in the absence of any bony metastases. Other than a transient response to furosemide-inducded diuresis he was refractory to treatment with oral inorganic phosphates and mithramycin. Ablation of the primary tumor did not affect his hypercalcemia. However, when therapy using external irradiation and parenteral bleomycin was directed to the metastases, his serum calcium stabilized and became normal and remained so until further progression of his humor. We postulate that the penile cancer metastases were elaborating parathyroid hormone-like substances responsible for the hypercalcemia and suppression of normal parathyroid activity.
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PMID:Metastatic carcinoma of penis complicated by hypercalcemia. 112 68


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