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

Multiple myeloma (MM) remains incurable. Despite many chemotherapy programs for large numbers of patients, there has been little improvement in outcome during the past 25 years. For many years, intermittent courses of melphalan and prednisone have represented the standard chemotherapy for newly diagnosed symptomatic MM. Many other drug combinations have been assessed, including regimens using multiple alkylating agents, and programs with vincristine, or an anthracycline, and have failed to show any superiority to melphalan-prednisone. Interferon alpha (IFN alpha) inhibits plasma cell growth and has induced responses in approximately 15% of previously untreated patients. This cytokine may have a role when used in those patients who have reached a good "plateau phase" with low tumor burden at the end of a chemotherapeutic program or after a transplantation procedure. The results of myeloablative therapy with allogenic or autologous marrow transplantation are promising and suggest possibility of a cure in some patients. Important problem in the management of MM patients is the treatment of complications, especially bone destruction, hypercalcemia, anemia and infections. Experimental modalities, especially immunotherapy, hold promise for use in humans and may also provide further insights into the pathogenesis of MM.
Acta Haematol Pol 1996
PMID:[Treatment of multiple myeloma--present status and perspectives]. 862 44

In the present paper a 67 years old female with chronic renal failure is reported, who developed at least three episodes of live-threatening hypercalcemia during long-term therapy with calcium carbonate. Results of biochemical and hormonal parameters and of dual x-ray photon absorptiometry (DEXA) were indicative for the presence of adynamic bone disease. Results obtained in this patient and published in the literature suggest, that presence of subnormal plasma concentrations of intact parathyroid hormone seems to be a valuable predictor of hypercalcemia in uremic patients treated with calcium carbonate.
Pol Arch Med Wewn 1996 May
PMID:[Life threatening hypercalcemia in a patient with chronic renal failure. Case report]. 884 14

The purpose of the study was to evaluate the effectiveness of the long-term oral pulse therapy with high doses of alphacalcidol (1 alpha (OH)D3) in severe uremic hyperparathyroidism. 43 hemodialysis patients with at least 5-fold 1-84 PTH serum elevation were given thrice a week oral (1 alpha (OH) D3) in doses up to 5 micrograms, according to serum calcium levels (monitored weekly). The drug was given in the evenings (Group A; 18 pts) or during hemodialysis sessions (Group B; 25 pts). The dialysate calcium was reduce to 1.40-1.45 mmol/l and CaCO3 was used as a main phosphate binder in doses up to 6 g/day; 13 pts received additionally small doses of Al (OH)3 (up to 3 g/day). After one month the PTH levels decreased by 67 +/- 7.7% (p < 0.001), while serum total calcium increased by 0.27 < or = 0.05 mmol/l. The parathyroid activity suppression progressed to 81 +/- 6.9% serum PTH reduction after 4 months and 74 +/- 6.1% fall after 8 months. Only 3 pts occurred to be non-responders; in 19 pts PTH levels normalized. A decrease of serum hydroxyproline and alkaline phosphatase with its bone isoenzyme activity was also observed with a direct correlation between those changes and parathyroid suppression. (1 alpha (OH) D3) dose at first month of therapy was 3.4 +/- 0.15 micrograms, but it was successively reduced because of hypercalcemia to a final dose of 2.2 +/- 0.22 micrograms. The frequency of hyperkalcemia was 7.6%; no difference between Group A and group B was noted. We conclude that oral (1 alpha (OH)D3) pulse therapy is very effective in the long-term parathyroid activity suppression in hemodialysis patients with severe hyperparathyroidism. To avoid dangerous hypercalcemia and relative hypoparathyroidism serum PTH and calcium levels should be carefully monitored.
Pol Arch Med Wewn 1996 Jul
PMID:[Long-term treatment with large doses of alphacalicidol in secondary hyperparathyroidism of patients dialyzed for end stage renal failure]. 896 41

The purpose of the study was to evaluate the effectiveness of the oral pulse therapy with high doses of alphacalcidol (1 alpha(OH)D3) in secondary hyperparathyroidism. 16 hemodialysis patients with 4 to 9-fold iPTH serum elevation were given ones in week oral 1 alpha(OH)D3 in doses from 5.0 to 7.0 micrograms (0.1 microgram/b.m.) according to serum levels of calcium, phosphate, activity of alkaline phosphatase with its bone fraction. Serum iPTH levels were measured every 3rd month of the treatment. The dialysate calcium was reduced to 1.25 mmol/l. CaCO3 was used as a main phosphate binder in doses from 3.0 to 9.0 g/day. After first three months of treatment the serum iPTH levels decreased from 486.0 +/- 200 pg/ml to 218.0 +/- 117 pg/ml (p = 0.0001). Calcium levels increased from 2.39 +/- 0.2 mmol/l to 2.52 +/- 0.29 mmol/l (p > 0.05). Phosphate levels increased from 2.15 +/- 0.67 mmol/l to 2.17 +/- 0.62 mmol/l (p > 0.05). Alkaline phosphatase levels decreased from 35.2 +/- 17.3 IU/l to 31.1 +/- 7.78 IU/l (p > 0.05). Bone isoenzyme of alkaline phosphatase decreased from 19.2 +/- 13.4 IU/l to 15.5 +/- 7.51 IU/l (p > 0.05). Because of early serum hypercalcemia, doses of 1 alpha(OH)D3 had to be reduced in 2 patients. In 8 patients (50%) demonstrating decrease of serum iPTH levels (below 200 pg/ml) after first 3 months of treatment doses of 1 alpha(OH)D3 were reduced in the following months. We conclude that oral 1 alpha (OH)D3 pulse therapy is effective for parathyroid activity suppression in patients with severe hyperparathyroidism. To avoid dangerous hypercalcemia and adynamic bone disease serum iPTH and calcium levels should be strictly monitored.
Pol Arch Med Wewn 1997 Oct
PMID:[Evaluation of the treatment efficacy of secondary hyperparathyroidism with oral pulse doses of alphacalcidol]. 955 90

Calcitonin is one of three most important factors involved in the regulation of systemic calcium homeostasis. Since its discovery in 1961 the structure of calcitonin from different species including human was established, synthetized and developed for use in human clinic. Up to now calcitonin is utilized in treatment of hypercalcemia, Paget disease, algodystrophy, primary and secondary osteoporosis and analgesia. Beside comparative studies aiming on selection of the most effective protocol of treatment and utilization, lately calcitonin is extensively studies for its antifracture potency in osteoporosis. One of the substantial therapeutical progress also appeared the utilization of intransal preparation of calcitonin.
Pol Merkur Lekarski 1998 Oct
PMID:[Calcitonin -- 1998]. 1010 52

Parathyroid cancer is a rare disease, causing 0.5% to 5.2% of primary hyperparathyroidism cases. Hyperparathyroidism accompanying a cancer is usually more severe with richer clinical symptomatology then hyperparathyroidism in the course of benign lesions. Every palpable neck tumour with high blood plasma calcium level should suggest the presence of parathyroid cancer. Development of cancer is slow but life prognosis depends on the extent of the first surgery. The prognosis is most favourable in case of 'en bloc' resection of tumour during the first surgical procedure. Therefore, diagnosis of cancer before operation is very important. If the surgery fails, the treatment should be aimed at lowering hypercalcaemia, which is the most common cause of the fatal sequel.
Pol Merkur Lekarski 2000 Mar
PMID:[Parathyroid cancer]. 1087 Apr 12

In this study, the biochemical and clinical profile of primary hyperparathyroidism, diagnosed in 155 patients (106 females and 49 males) in the Department of Nephrology of the Silesian University School of Medicine in the years 1972-1998 was analyzed. The mean age of patients was 48.5 +/- 12.8 years. In all cases the diagnosis was confirmed by the pathomorphological examination. In the majority of cases PNP was diagnosed in a phase of advanced organic injuries. The leading clinical finding in these patients was nephrolithiasis. Asymptomatic hypercalcemia was diagnosed only in 9% of cases. In the years 1972-1992 elevated serum total calcium concentration was found in 92.6% while after introduction of routine estimation of ionized calcium concentration in 1993, hypercalcemia was found in all patients. The incidence of hypercalciuria increased significantly in patients diagnosed in the period 1993-1998 while in this same period the incidence of impaired renal function declined significantly. The elevated serum PTH was found in 86% of patients regardless whether C-terminal fragments of PTH or intact PTH-1-84 were assessed. Elevated levels of ionized serum calcium with normal or increased plasma iPTH-1-84 level are the most constant symptoms of primary hyperparathyroidism.
Pol Arch Med Wewn
PMID:[Clinical and biochemical picture of primary hyperparathyroidism based on 155 observed cases]. 1123 60

Physiological principles are presented of calcium receptor (CaR) as well as agents affecting the receptor, defined as calcimimetics. Positive influence of type 1 and type 2 calcimimetics on calcium metabolism is discussed. The clinical indications for calcimimetics, especially type 2, in the future, seem to be hypercalcemia in the course of primary and secondary hyperparathyroidism as well as hypercalcemia in patients with parathyroid carcinoma.
Pol Merkur Lekarski 2002 Nov
PMID:[Calcimimetics as a new chance for effective treatment of calcium metabolism disturbances]. 1262 66

The frequent association of thyroid and parathyroid disorders has been reported. Most commonly, hyperthyroidism may coexist with hypercalcemia, but the latter is successfully treated when euthyroidism is achieved. However, the concomitant hyperthyroidism with primary hyperparathyroidism is of a rare occurrence. Moreover, it may frequently go unrecognized. In this paper we report a case of a patient with hypercalcemia due to PTH--secreting parathyroid adenoma associated with hyperthyroidism due to toxic nodular goiter. This case demonstrates the dramatic outcome of those two coexisting disorders. We point out that in patients with primary hyperparathyroidism thyroid function test should always be carried out. A proper, first-line treatment of hyperthyroidism will prevent the deterioration of primary hyperparathyroidism course, and thus surgical parathyroid treatment may safely be introduced.
Pol Arch Med Wewn 2003 Feb
PMID:A rare coexistence of primary hyperparathyroidism and hyperthyroidism due to toxic nodular goiter--a case report. 1287 80

Sarcoidosis is a granulomatous disease of unknown origin characterized by the trend to spontaneous remission in the great number of the patients. Some patients require treatment with corticosteroids, which have significant toxicity. The aim of this study was to assess the prognostic role of many different parameters in the patients with sarcoidosis. 162 sarcoidosis patients were introduced to prospective study: 22 patients were treated because of deterioration in lung function or serious ocular disease and 140 were observed without therapy for two years. We assessed the age, sex, symptoms, serum activity of angiotensin converting enzyme (SACE), hypercalcaemia, hypercalciuria, splenomegaly and HRCT findings at the time of diagnosis. We analyzed the frequency of spontaneous remission of sarcoidosis in the untreated patients. We investigated correlation between these parameters and remission. Statistical comparisons were made with chi-square test. We also applied the k nearest neighbor (k-NN) rule and the leave one out method adopted from the statistical pattern recognition theory. From many different parameters only acute symptoms (erythema nodosum, fever, arthritis) and serum activity of ACE might be helpful in predicting prognosis in the patients with stage I of disease. The patient's age at onset less than 36 years, the appearance of erythema nodosum and ground-glass opacities on HRCT scans portend an excellent prognosis in the patients with stage II of disease.
Pneumonol Alergol Pol 2002
PMID:[Prognostic value of some clinical, radiological, laboratory and functional parameters in sarcoidosis]. 1288 67


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