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Synchronous Double Primary Cancer Complicated With Severe Hypercalcemia.

Hypercalcemia of malignancy (HCM) is an important cancer-related medical emergency. It is a sign of advanced disease with a poor prognosis. We report a case of a 55-year-old man who presented with decreased sensorium, constipation for 4 days, dysphonia, and weight loss for the past three months. The physical examination showed a petrous nodular lesion of the neck in relation to the right sternocleidomastoid muscle. The digital rectal examination showed an enlarged prostate with a nodule of hard consistency. The blood revealed a hypercalcemia of 18.9 mg/dl and a prostate-specific antigen of 319…

PROLONGED HYPERCALCEMIA FROM ANTIBIOTIC-ELUTING CALCIUM SULFATE BEADS.

OBJECTIVE: Calcium sulfate beads (CSBs) are biocompatible hydrophilic crystals that are used to deliver local antibiotics in periprosthetic joint infections. Hypercalcemia after placement of CSBs is uncommon and poorly understood. METHODS: We present the case of a woman who presented with symptomatic hypercalcemia after placement of antibiotic-eluting CSBs. RESULTS: A 58-year-old, Caucasian woman presented with altered mental status, respiratory failure, and septic shock 2 days after placement of antibiotic-eluting CSBs for a left prosthetic hip infection. Laboratory analysis revealed severe…

Systemic lupus erythematosus-related hypercalcemia with ectopic calcinosis.

We report a case of a 39-year-old female with active systemic lupus erythematosus who complained of lethargy and weakness with a moderate renal impairment. Hypercalcemia was confirmed by laboratory examination. Her X-ray revealed significant ectopic calcinosis in subcutaneous tissue of bilateral hands, and Tc-99(m) methylene diphosphonate bone scan revealed a remarkably intense uptake of bilateral lungs. She had no evidence suggestive of other diseases related to hypercalcemia such as hyperparathyroidism and malignancy. She had abnormally high serum parathyroid hormone-related protein (PTHrP) …

Hypercalcemia associated with mineral oil-induced sclerosing paraffinomas.

OBJECTIVE: Granuloma-forming diseases such as sarcoidosis are associated with extrarenal synthesis of 1,25-dihydroxyvitamin D [1,25(OH)₂D]. We describe a case of extensive skin lesions associated with mineral oil injections in which we provide evidence for cutaneous granuloma synthesis of 1,25(OH)₂D in the pathogenesis of the patient's hypercalcemia. METHODS: Analysis of expression of the 25(OH)D-1a-hydroxylase (1-a OHase [CYP27b1]) was carried out by immunohistochemical analysis of involved skin. RESULTS: In involved skin, expression of CYP27b1 was found in the dermis, where it is not norma…

Systemic lupus erythematosus presenting as acute symptomatic hypercalcemia.

Hypercalcemia is a common electrolyte abnormality with a wide differential diagnosis. Primary hyperparathyroidism and malignancy are the most frequent causes, accounting for more than 90% of cases. We report the case of a woman presenting with symptomatic severe hypercalcemia, who was subsequently diagnosed with systemic lupus erythematosus (SLE) due to the presence of arthritis, lymphopenia, antinuclear antibodies (ANA), anti-DNA and anti-Ro antibodies and low C3 levels. After acute treatment with intravenous fluids, steroids, diuretics and pamidronate, calcium levels corrected and have remai…

Hypercalcemia-induced renal insufficiency during therapy with dihydrotachysterol.

During vitamin-D therapy drug accumulation and intoxication should be considered. In the present study we report on five patients with renal insufficiency during therapy with dihydrotachysterol or calcitriol. Four patients received dihydrotachysterol for 29 (7-44) years and one patient received calcitriol for 4 years to treat hypoparathyroidism after thyroid surgery. As confirmed by renal biopsy impairment of renal function was due to calcifications as a consequence of prolonged hypercalcemia. The effective duration of dihydrotachysterol is ten days as compared with five days for calcitriol. S…

Vitamin D metabolite-mediated hypercalcemia in Wegener's granulomatosis.

Hypercalcemia may occur during the course of various granuloma-forming diseases. Herein we describe a patient who had symptomatic hypercalcemia as a prominent sign of Wegener's granulomatosis. We observed a direct correlation between the serum levels of 1,25-dihydroxyvitamin D [1,25(OH)2D] and both the serum and the urinary calcium levels. Administration of prednisone and cyclophosphamide led to a substantial decrease in the levels of calcium and serum 1,25(OH)2D, but the serum levels of 25-hydroxyvitamin D remained unchanged. Two months after admission of the patient, the levels of calcium an…

Parathyroid gland morphology in nonparathyroid hormone-mediated hypercalcemia.

Occasionally, patients with other causes of hypercalcemia undergo parathyroidectomy for suspected primary hyperparathyroidism. We studied the parathyroid glands from 12 persons with nonparathyroid hypercalcemia. Glands from these individuals were similar to normal glands in size and fat:parenchymal ratio, showing neither atrophy nor hyperplasia. A distinctive histologic feature, also seen in hyperparathyroid hypercalcemia, is the presence of pale, vacuolated cells arranged in a trabecular pattern. Recognition of normal parathyroid parenchymal weight and the nonspecific nature of these vacuolat…

PTHrP-associated hypercalcemia in gynecologic malignancies: a scoping review.

PURPOSE: Parathyroid hormone-related peptide (PTHrP) is a peptide hormone that shares structural similarity with parathyroid hormone (PTH) and binds to the same receptor, leading to increased calcium levels. Humoral hypercalcemia of malignancy (HHM) is typically mediated by tumor-derived PTHrP and accounts for the majority of cases of malignancy-associated hypercalcemia, whereas it is rarely observed in benign conditions. The purpose of this study was to systematically review the literature to map and provide a structured and transparent overview of reported cases of HHM in malignant gynecolog…

Pamidronate Dose Response for Hypercalcemia in Burn-Injured Patients.

Hypercalcemia after a burn injury is attributed to bone resorption secondary to muscle inactivity and prolonged immobilization. Evidence to guide treatment is extremely limited. The purpose of this study was to assess the effect of pamidronate on hypercalcemia in patients with burn injuries. This retrospective, observational study was conducted at a regional burn center. Adult patients admitted to the burn surgery service who received IV pamidronate for hypercalcemia during hospitalization were included. The primary outcome was the change in ionized calcium (iCa) at days 7 and 14 after pamidro…

Ингибиция Calpain-2 смягчает гиперкальцемию, вызванную несколькими миеломами.

Множественная миелома (ММ) — злокачественное гематологическое расстройство, характеризующееся неопластическим распространением плазменных клеток. Гиперкальцемия является распространенным осложнением в MM и часто считается вторичным последствием развития болезни. Когда уровень кальция сильно повышен, он может привести к коме у больных. Однако остается неясным, играет ли гиперкальцемия непосредственную роль в развитии ММ. Здесь мы обнаружили, что высокие концентрации кальция способствуют распространению клеток MM и связаны с кальпаином-2 (CAPN2). Мы также отметили, что выражение CAPN2 значительн

Совпадение в аннотации оригинала
Multiple myeloma (MM) is a malignant hematological disorder characterized by the neoplastic proliferation of plasma cells. Hypercalcemia is a common complication in MM and is often considered a secondary consequence of disease progression. When calcium levels are severely elevated, it can lead to coma in affected patients. However, whether hypercalcemia play…

Acute Hypercalcemia Resulting From Antibiotic-Impregnated Calcium Sulfate Beads.

An 86-year-old man with a history of chronic kidney disease sustained a hip fracture after a mechanical fall, which eventually led to a total hip arthroplasty (THA). During this THA, he was found to have a prosthetic joint infection and underwent debridement, antibiotics, and implant retention, where calcium sulfate beads (CSBs) were placed. He subsequently developed hypercalcemia, requiring intravenous fluids, diuretics, and calcitonin for treatment. This case highlights the development of hypercalcemia after the placement of CSBs, which is a known, although uncommon, side effect.

Idiopathic Arginine Vasopressin Deficiency With Mild and Reversible Hypercalcemia.

BACKGROUND: Arginine vasopressin deficiency (central diabetes insipidus) results from impaired hypothalamic-neurohypophyseal secretion of arginine vasopressin and leads to hypotonic polyuria and polydipsia. Common causes of arginine vasopressin deficiency include head trauma, pituitary surgery, neoplasms, and inflammatory stalk lesions; however, 25% to 50% of cases are idiopathic. Hypercalcemia can result in arginine vasopressin resistance (nephrogenic diabetes insipidus) and is an important differential in the evaluation of patients with hypotonic polyuria-polydipsia syndrome. CASE REPORT: A…

A Rare Case of Hypercalcemia from Mediastinal Ectopic Hyperparathyroidism.

Hypercalcemia is frequently attributed to primary hyperparathyroidism, commonly a result of parathyroid adenomas. Ectopic hyperparathyroidism is characterized by hyperfunctioning parathyroid tissue located outside of expected anatomical locations of endocrine tissue. In this report, we present a rare case of hypercalcemia secondary to a mediastinal ectopic parathyroid adenoma, located between the left atrium and pulmonary artery. Given the unique location of the ectopic gland, diagnosis was delayed with additional complications that followed due to difficulty accessing the gland surgically. De…

Severe Hypercalcemia Revealing Acute Lymphoblastic Leukemia: A Case Report.

Hypercalcemia is a rare metabolic disorder in children, with a wide range of potential etiologies, some of which can be life-threatening. We report the case of a 2.5-year-old male child admitted for progressive lower limb muscle weakness that began one month prior to admission, associated with abdominal pain and vomiting. Initial investigations revealed severe hypercalcemia at 21.2 mg/dL (5.28 mmol/L), accompanied by hypercalciuria, hypophosphatemia, and vitamin D deficiency. The patient was transferred to pediatric intensive care due to the onset of malignant hypercalcemia, altered consciousn…

An Unusual Etiology of Recurrent Parathyroid Hormone-Independent Hypercalcemia.

The diagnosis of parathyroid hormone (PTH)-independent hypercalcemia can be challenging due to its heterogeneous etiology. We report a case of a 65-year-old woman diagnosed with PTH-independent hypercalcemia 7 years prior. In view of elevated serum acetylcholine esterase and 1,25-dihydroxyvitamin D, a granulomatous etiology was suspected. The 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) revealed diffuse uptake in the axial and appendicular muscles, suggestive of sarcoidosis of muscle. She responded to a 6-week course of glucocorticoids, with normalizat…