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Topic: Hypercalcaemia

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Acute pancreatitis

	Hypercalcaemia
		Eighty percent of hypercalcaemia are due to metastatic disease, half of which are due to myeloma and the rest due to metastases from the primary cancers of breast, lung, kidney, prostate, cervix, and head and neck.
		Hypercalcaemia interferes with renal mechanism of sodium and water reabsorption causing polyuria and dehydration.
		It is not effective in hypercalcaemia caused by non-haematologic cancer except that caused by the flare effect of hormone therapy of breast cancer.
	members.optusnet.com.au /~vchan/Hypercalcaemia.htm (1832 words)

	Rocaltrol , Rocaltrol Side Effects, Rocaltrol Information
		Rocaltrol should not be given to patients with hypercalcaemia or evidence of metastatic calcification.
		Hypercalcaemia and hypercalcuria are the major side effects of Rocaltrol and indicate excessive dosage.
		In patients with normal renal function, chronic hypercalcaemia may be associated with an increase in serum creatinine.
	www.medisave.ca /DrugMoreInfo2003.aspx (561 words)

	Health & Beauty: information and advice to make your life healthy and your body beautiful
		Hypercalcaemia occurs when total circulating serum calcium is in excess of 2.55 mmol/L. This is usually found by chance in patients without significant symptoms when calcium is checked when "routine tests" are done.
		The most common cause for hypercalcaemia in someone with relatively mild symptoms is primary hyperparathyroidism (see hyperparathyroidism) whereas in patients who are unwell and hospitalised, the most common cause is malignancy.
		Hypercalcaemia results when there is a breakdown of the normal control mechanisms for regulating normal serum calcium concentrations.
	ivillage.medicdirect.co.uk /diseases.asp?step=4&pid=1418 (435 words)

	Update on Hypercalcaemia in Malignancy
		Hypercalcaemia is the most common life threatening metabolic disorder associated with cancer.
		Dr Gurney became interested in hypercalcaemia in malignancy (HCM) during his post-fellowship oncology training in Britain in the late 1980s and was involved in research into the pathophysiology of HCM.
		Malignancy is the commonest cause of hypercalcaemia, accounting for almost 50% of cases in a British hospital series.
	www.medicineau.net.au /clinical/palliative/Hypercalcaemia.html (872 words)

	HYPERCALCAEMIA:
		Hypercalcaemia caused by vitamin D can be due to excessive ingestion or abnormal metabolism of the vitamin.
		Hypercalcaemia can be managed in these cases by avoiding exposure to sunlight and by limiting intake of vitamin D and calcium.
		Incidence of hypercalcaemia in patients with hyperthyroidism is ~20%.
	www.portfolio.mvm.ed.ac.uk /studentwebs/session3/45/hypercal.htm (1527 words)

	Metabolic emergencies (1) - Hypercalcaemia
		Hypercalcaemia is a usual manifestation of cancers: 20 – 40 % of multiple myeloma, 35% of lung cancers, 24% of kidney cancers, 8-10% of breast cancer.
		Hypercalcaemia generally underlines the poor prognosis of cancer, although the new therapies may allow a longer survival of patients.
		A malignant hypercalcaemia is easy to distinguish to other hypercalcaemia : generally blood phosphorous is normal or elevated (difference with hyperparathyroidism).
	www.oncoprof.net /Generale2000/g16_Urgences/gb16_ur10.html (391 words)

	Hypercalcaemia of malignancy
		Hypercalcaemia is a common problem in advanced malignancy affecting 10% of patients to varying degrees.
		Hypercalcaemia of malignancy is a feature of advanced disease and carries with it a poor prognosis.
		In myeloma, hypercalcaemia is produced by the stimulation of osteoclasts by interleukin-1 and tumour necrosis factor, which again promotes calcium loss from bone.
	www.medicineau.net.au /clinical/palliativecare/palliativec1257.html (785 words)

	One Alpha , SPC from the IPHA Electronic Medicines Compendium
		Early hypercalcaemia is more likely in patients with autonomous hyperparathyroidism, those with histologically 'pure' osteomalacia related possibly to phosphate depletion or aluminium intoxication, and those dialysed against a high dialysate calcium concentration.
		Hypercalcaemia can be rapidly corrected by stopping treatment until plasma calcium levels return to normal (in about one week).
		Symptoms and signs which may occur in association with hypercalcaemia are diarrhoea, constipation, nausea, vomiting, dry mouth, metallic taste, hypercalciuria, polyuria, polydipsia, headache, dizziness, confusional state, myalgia, bone pain, irregular heartbeat, pruritus and fatigue.
	www.medicines.ie /emc/assets/c/html/displayDocPrinterFriendly.asp?DocumentId=5747 (1681 words)

	Digoxin, hypercalcaemia, and cardiac conduction -- Vella et al. 75 (887): 554 -- Postgraduate Medical Journal
		The cardiac effects of hypercalcaemia are usually manifest as a shortening of the QT-interval.
		tend to be prolonged by hypocalcaemia and shortened by hypercalcaemia.
		Cardiac disease, or the underlying cause of hypercalcaemia,
	pmj.bmjjournals.com /cgi/content/full/75/887/554 (1367 words)

	Breast Cancer Research \| Full text \| The role of bisphosphonates in breast cancer: The present and future role of ...
		Zoledronic acid has yielded impressive results in the treatment of hypercalcaemia and bone pain associated with bone metastases [4], and is at least as effective as pamidronate in the prevention of skeletal morbidity from breast cancer [5,6].
		Hypercalcaemia is the most common metabolic complication of malignancy and it is important to recognise because it is associated with a range of unpleasant gastrointestinal and neurological side effects.
		Parathyroid hormone related protein levels are often raised in patients with hypercalcaemia and appear to have an important role in humoral hypercalcaemia of malignancy [9].
	breast-cancer-research.com /content/4/1/24 (3702 words)

	Calcijex 2 microgram/ml Solution for Injection , SPC from the eMC (Site not responding. Last check: 2007-10-24)
		Calcijex should not be given to patients with hypercalcaemia or evidence of vitamin D toxicity.
		Excessive dosage of Calcijex induces hypercalcaemia, and in some instances hypercalciuria; therefore, early in treatment during dosage adjustment, serum calcium and phosphate should be determined at least twice weekly.
		Progressive hypercalcaemia due to overdosage of vitamin D and its metabolites may be so severe as to require emergency attention.
	emc.medicines.org.uk /emc/assets/c/html/displaydoc.asp?DocumentID=5270 (2048 words)

	Hypercalcaemia -- a hospital survey (Site not responding. Last check: 2007-10-24)
		Hypercalcaemia -- a hospital survey 49(196): 405-418, 1980.
		In order to provide information about the prevalence of hypercalcemia and its different causes, a retrospective survey was carried out in all hospital in-patients in whom serum calcium was elevated.
		Two hundred and nineteen cases of hypercalcemia with malignancy were found together with 68 cases with chronic renal failure and 59 cases of primary hyperparathyroidism.
	www.meb.uni-bonn.de /cgi-bin/mycite?ExtRef=ICDB/81611864 (104 words)

	E-Doc INTERACTIVE - Review
		Many conditions are associated with hypercalcaemia: primary hyperparathyroidism, advanced secondary hyperparathyroidism, milk alkali syndrome, vitamin D intoxication, thiazide diuretic treatment, malignancy with or without bone metastases, and immobilisation.
		Hypercalcaemia is a relative frequent phenomenon in many malignant disorders.
		In high levels of hypercalcaemia of long duration anorexia, abdominal pain with vomiting, constipation and nephrolithiasis are common.
	www.edoc.co.za /modules.php?name=News&file=article&sid=498 (1177 words)

	Data Sheet
		It is important to adjust dosage thereafter according to the biochemical responses and to avoid hypercalcaemia.
		If hypercalcaemia occurs, One-Alpha medication should be stopped immediately until serum calcium levels return to normal (in about one week) and then re-started at half the previous dose.
		Severe hypercalcaemia may require additional treatment with a "loop" diuretic and intravenous fluids or with corticosteroids.
	www.medsafe.govt.nz /Profs/Datasheet/o/OneAlphacapdropinj.htm (947 words)

	Untitled1 (Site not responding. Last check: 2007-10-24)
		Adverse effects generally relate to hypercalcaemia and, in the case of renal impairment, hyperphosphataemia which may be induced by alfacalcidol therapy.
		Indices of response, in addition to a rise in plasma calcium, may include a progressive reduction in alkaline phosphatase, a reduction in parathyroid hormone levels, an increase in urinary calcium excretion in patients with normal renal function, bone radiography and histological improvements.
		Manifestations: Hypercalcaemia which may manifest clinically as malaise, fatigue, weakness, dizziness, drowsiness, headache, nausea, dry mouth, constipation, diarrhoea, heartburn, vomiting, abdominal pain, gastrointestinal discomfort, muscle pain, bone pain, joint pain, pruritus or palpitations.
	www.panacea-biotec.com /products/Alphadol_c.htm (1195 words)

	Hypercalcaemia in T cell acute lymphoblastic leukaemia: report of two cases.
		Hypercalcaemia in T cell acute lymphoblastic leukaemia: report of two cases.
		Two young adults presenting with acute lymphoblastic leukaemia (ALL) associated with hypercalcaemia and osteolytic lesions were both found to have T cell ALL.
		Hypercalcaemia is a rare feature of ALL and has not previously been related to T cell disease.
	www.aegis.com /aidsline/1987/mar/M8730024.html (317 words)

	Hypercalcaemia - Patient UK (Site not responding. Last check: 2007-10-24)
		If the hypercalcaemia is long standing, calcium may be deposited in soft tissues or may result in stone formation e.g.
		Causes of raised calcium levels Hypercalcaemia is most commonly thought of in two ways, either due to raised parathormone levels, or due to causes other than raised parathormone (PTH) levels, and the initial step in the investigation is to determine which group a patient lies in.
		Non-Drug Asymptomatic patients with PTH mediated hypercalcaemia which doesn’t meet the recognised criteria for surgery may be treated conservatively with regular monitoring of bone density, renal function and serum and urinary calcium levels.
	www.patient.co.uk /showdoc/40001113 (838 words)

	Data Sheet
		Biochemical changes reflecting the inhibitory effect of Pamisol on tumour-induced hypercalcaemia, are characterised by a decrease in serum calcium and phosphate and secondarily by decreases in urinary excretion of calcium, phosphate, and hydroxyproline.
		Hypercalcaemia can lead to a depletion in the volume of extracellular fluid and a reduction in the glomerular filtration rate (GFR).
		However, in patients with multiple myeloma and in patients with tumour-induced hypercalcaemia, it is recommended not to exceed 90 mg in 500 mL over 4 hours.
	www.medsafe.govt.nz /profs/datasheet/p/Pamisolinj.htm (2305 words)

	Octreotide in the treatment of pthrp related hypercalcaemia in neuroendocrine tumours: a case report and literature ...
		Hypercalcaemia may be severe and refractory to conventional treatment.
		Case: A 27 yr old man was referred with resistant hypercalcaemia and a 3 yr history of metastatic NET (corrected Ca =4.69 mmol/L; NR 2.2–2.6 mmol/L).
		Hypercalcaemia was refractory to saline rehydration, intranasal calcitonin, and intravenous bisphosphonate.
	www.endocrine-abstracts.org /ea/0010/ea0010p42.htm (354 words)

	Rocaltrol , SPC from the eMC
		Calcitriol dosage must be determined with care in patients undergoing treatment with digitalis, as hypercalcaemia in such patients may precipitate cardiac arrhythmias.
		Severe or persistent hypercalcaemia may be treated by administering corticosteroids, ensuring adequate hydration, inducing a diuresis where practicable and by general supportive measures.
		Calcitriol has the greatest biological activity of the known vitamin D metabolites and is normally formed in the kidneys from its immediate precursor, 25-hydroxycholecalciferol.
	emc.medicines.org.uk /emc/assets/c/html/displaydoc.asp?DocumentID=1728 (1892 words)

	s000519b - Hypothyroidism and Adrenal Insufficiency
		This is the third case to be described of hypercalcaemia: occurring in association with lymphocytic hypophysitis.
		Hypercalcaemia is not a recognized complication of other forms: of pituitary failure.
		Reduced renal: excretion of calcium due to a reduction in calcium delivery to the glomerulus and increased proximal tubular reabsorption: are also implicated in the aetiology of hypercalcaemia associated with adrenal failure.
	www.emory.edu /WHSCL/grady/amreport/litsrch99/s000519b.html (1919 words)

	The Society for Endocrinology - Training (Site not responding. Last check: 2007-10-24)
		The most important factors in delineating hypercalcaemia are to determine whether hypercalcaemia is responsible for the patients symptoms and secondly to decide whether the hypercalcaemia is parathyroid or non-parathyroid in origin since over 90% of hypercalcaemic cases in a hospital setting will be from either primary hyperparathyroidism or malignant hypercalcaemia.
		Patients who are otherwise well where hypercalcaemia has been discovered fortuitously will either have primary hyperparathyroidism or a variant, familial hypocalciuric hypercalcaemia (F.H.H) (caused by a missense mutation in the calcium sensing receptor).
		When hypercalcaemia is present with low serum PTH, a non-parathyroid cause should be sought such as carcinoma of the lung, pancreas, breast, ovary, prostate, myeloma, lymphoma, sarcoid.
	www.endocrinology.org /sfe/training/ss03/ss03_dav.htm (571 words)

	Pathogenesis of hypercalcaemia of malignancy.
		In most cases, hypercalcaemia is due to a combination of increased bone resorption associated with decreased renal capacity to excrete the increased extracellular fluid calcium.
		In solid tumours such as carcinoma of the lung, tumour-derived growth factors are probably primarily responsible for the increased bone resorption, and a separate family of factors which interact with some parathyroid hormone (PTH) receptors cause increased renal tubular calcium reabsorption.
		Some T-cell lymphomas in addition have the capacity to metabolize 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D. In myeloma, impaired glomerular filtration frequently contributes to the pathogenesis of hypercalcaemia by impairing renal compensatory mechanisms for maintaining normal serum calcium concentrations in the presence of increased bone resorption.
	www.aegis.com /aidsline/1986/jul/M8670140.html (373 words)

	Hypercalcaemia in infancy; a presenting feature of spinal muscular atrophy -- Khawaja et al. 89 (4): 384 -- Archives of ... (Site not responding. Last check: 2007-10-24)
		Hypercalcaemia in infancy; a presenting feature of spinal muscular atrophy -- Khawaja et al.
		Hypercalcaemia in infancy; a presenting feature of spinal muscular atrophy
		Calcium-sensing receptor mutations in familial benign hypercalcaemia and neonatal hyperparathyroidism.
	adc.bmjjournals.com /cgi/content/full/89/4/384 (1222 words)

	The South African Medicines Formulary: CALCIUM HOMEOSTASIS
		Hypercalcaemia may occur in a number of diverse clinical conditions.
		Six to eight litres of 0.9% saline are given over the first 48 hours; in patients vulnerable to fluid overload central venous pressure needs monitoring.
		Indications: Hypercalcaemia of malignancy; osteolysis due to bone metastases from solid tumours or due to haematological neoplasms.
	web.uct.ac.za /depts/mmi/jmoodie/h05html.html (1383 words)

	eMJA: 8: Disorders of bone and mineral other than osteoporosis (Site not responding. Last check: 2007-10-24)
		Cancer can also produce hypercalcaemia if the capacity of the kidneys to excrete the calcium dissolved from bone is exceeded; treatment is with saline infusion to increase excretion and a bisphosphonate.
		Lytic bone disease is mediated by the osteoclast, and sclerotic bone disease by the osteoblast.
		In humoral hypercalcaemia of malignancy, circulating hormonal factors produced by malignant tissue, such as PTH-related peptide, induce hypercalcaemia by increasing bone resorption and reducing renal calcium excretion through effects on the PTH receptor.
	www.mja.com.au /public/issues/180_07_050404/pri10364_fm.html (3610 words)

	Clinical impact of bone and calcium metabolism changes in sarcoidosis -- Rizzato 53 (5): 425 -- Thorax
		Hypercalcaemia in sarcoidosis was first demonstrated in 1939.
		Hypercalcaemia and hypercalciuria are usually asymptomatic but the toxic effects of calcium on renal tubules may produce symptoms
		Hypercalcaemia, hypercalciuria and calcaemic nephropathy may be prevented by a low calcium diet, adequate hydration, and minimisation
	thorax.bmjjournals.com /cgi/content/full/53/5/425?eaf (2933 words)

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