We present a case report of a severe hypercalcemia due to a rare association and review the relevant literature. [ncbi.nlm.nih.gov]

The poster will present the clinical case of a patient with hypercalcemia (serum corrected calcium 14.2 mg/dL) in the setting of progression of well differentiated metastatic neuroendocrine tumor who presented with dehydration, progressive muscle weakness [advancedpractitioner.com]

• Fatigue

  We report the case of a 63-year-old man who presented with weakness, fatigue, dehydration, confusion, abdominal pain, congestive heart failure and hypercalcemia. [ncbi.nlm.nih.gov]

  Patients with mild hypercalcemia (serum calcium 10.5-12 mg/dL) can present with constipation, fatigue, and depression. [advancedpractitioner.com]

  The most common adverse reactions in patients receiving XGEVA ® for giant cell tumor of bone were arthralgia, headache, nausea, back pain, fatigue, and pain in extremity. [xgeva.com]

  Complicating diagnosis, the same symptoms common to advanced cancer are also seen in hypercalcemia of malignancy: nausea, constipation, anorexia, malaise and fatigue. [acphospitalist.org]

  But the first signs might be: extreme tiredness (fatigue) and lethargy feeling weak not wanting to eat much constipation loss of concentration and interest in doing things mild confusion low mood irritability Untreated high calcium symptoms Untreated [cancerresearchuk.org]

• Falling

  The 30 mg/kg group had adjusted serum calcium levels fall from a mean preinfusion baseline of 13.8 +/- 0.4 mg/dl to a mean nadir of 10.5 +/- 0.3 mg/dl. [ncbi.nlm.nih.gov]

  Serum calcium levels may fall precipitously and may stay down for several days after surgery,” he said. The patient will need to remain in the hospital and be treated with oral and/or IV calcium supplements, and calcitriol, he added. [acphospitalist.org]

  Mechanisms of Malignancy-Associated Hypercalcemia Perturbations of calcium regulation in patients with hypercalcemia of malignancy fall into three general categories ( Figure 1 ). [cjasn.asnjournals.org]

  This therapy can be repeated daily for 3 to 4 days, and the serum calcium lowering effect begin to fall within 12 hours of initiation. [oatext.com]

  The rise and fall of primary hyperparathyroidism: a population-based study in Rochester, Minnesota, 1965–1992. Ann Intern Med. 1997;126:433–40. 4. Al Zahrani A, Levine MA. Primary hyperparathyroidism. Lancet. 1997;349:1233–8. 5. [aafp.org]

• Nausea

  The most common adverse reactions in patients receiving XGEVA ® for giant cell tumor of bone were arthralgia, headache, nausea, back pain, fatigue, and pain in extremity. [xgeva.com]

  Dehydration caused by nausea and vomiting makes it hard for the kidneys to remove calcium from the blood properly. Lack of physical activity can cause bone to break down, releasing calcium into the blood. [cancer.net]

  The most common (>10%) symptoms at baseline were fatigue, anorexia, nausea, lethargy, and constipation. [academic.oup.com]

  However, mithramycin is not commonly recommended in hypercalcemia associated with malignancy due to dose-related adverse effects including nausea, vomiting, stomatitis, thrombocytopenia, and renal and hepatotoxicity. [oatext.com]

  Typical symptoms include nausea, vomiting, constipation, abdominal pain, anorexia, weight loss, bone pain, polyuria, fatigue, and weakness. [cjasn.asnjournals.org]

• Vomiting

  This can be managed by: Treating the cancer Replacing fluids lost through vomiting, frequent urination, or other reasons Taking medicines to help stop the breakdown of bone. [cancer.net]

  However, mithramycin is not commonly recommended in hypercalcemia associated with malignancy due to dose-related adverse effects including nausea, vomiting, stomatitis, thrombocytopenia, and renal and hepatotoxicity. [oatext.com]

  Typical symptoms include nausea, vomiting, constipation, abdominal pain, anorexia, weight loss, bone pain, polyuria, fatigue, and weakness. [cjasn.asnjournals.org]

  Symptoms include nausea, vomiting, abdominal pain, bone pain, fatigue, and confusion. Ultimately, HCM can result in renal failure, coma, and death, with an estimated 50% survival of 30 days regardless of treatment ( 4 ). [academic.oup.com]

  They may include nausea, vomiting, lethargy, cardiac dysrhythmias, seizures, muscle cramps, and renal failure. 28,29 Although symptoms may occur before the start of ChT, they are more commonly observed within 12 to 72 hours after initiation of cytotoxic [uspharmacist.com]

• Abdominal Pain

  We report the case of a 63-year-old man who presented with weakness, fatigue, dehydration, confusion, abdominal pain, congestive heart failure and hypercalcemia. [ncbi.nlm.nih.gov]

  pain and/or shortness of breath amongst many other clinical manifestations. [sciencedomain.org]

  People with hypercalcemia may have the following symptoms: Loss of appetite Nausea and vomiting Constipation and abdominal pain Increased thirst and frequent urination Fatigue, weakness, and muscle pain Confusion, disorientation, and difficulty thinking [cancer.net]

  pain Vomiting Dehydration Lethargy Cardiac arrhythmias, shortened QT interval Coma Pancreatitis If the hypercalcaemia is long-standing, calcium may be deposited in soft tissues or may result in stone formation - eg, nephrocalcinosis, nephrolithiasis [patient.info]

• Polydipsia

  Those with moderate hypercalcemia (12 to 14 mg/d) can develop polydipsia, polyuria, clinical dehydration, muscle weakness, and changes in mental status. Those with severe hypercalcemia can develop severe form of these symptoms. [advancedpractitioner.com]

  Hypercalcemia itself can contribute to other complications such as nausea, constipation, polyuria, polydipsia, nephrolithiasis and renal insufficiency. [karger.com]

  Presentation of Hypercalcaemia At levels At levels At levels >3.5 mmol/L Polyuria and polydipsia Dyspepsia - due to calcium-regulated release of gastrin Depression Mild cognitive impairment All of the previous plus: Muscle weakness Constipation Anorexia [patient.info]

  […] to 11.9 mg/dL; that for moderate hypercalcemia, 12.0 to 13.9 mg/dL; and that for severe hypercalcemia, ≥14.0 mg/dL. 3 A mildly elevated serum calcium concentration tends to evoke no symptoms, whereas moderate elevations can cause anorexia, polyuria, polydipsia [uspharmacist.com]

  The most important renal effects are polydipsia and polyuria resulting from nephrogenic diabetes insipidus, and nephrolithiasis resulting from hypercalciuria. Other renal effects include dehydration and nephrocalcinosis. [aafp.org]

• Loss of Appetite

  People with hypercalcemia may have the following symptoms: Loss of appetite Nausea and vomiting Constipation and abdominal pain Increased thirst and frequent urination Fatigue, weakness, and muscle pain Confusion, disorientation, and difficulty thinking [cancer.net]

  Symptoms of hypercalcemia include: nausea vomiting loss of appetite, or anorexia constipation fatigue muscle weakness increased thirst frequent and increased urination dark yellow urine little or no sweating abnormal heart rhythm weaker muscle reflexes [cancer.ca]

• Osteoporosis

  The drug will be an interesting addition to the available drugs for osteoporosis, bone metastases, and hypercalcemia of malignancy. [ncbi.nlm.nih.gov]

  Horowitz E, Miller JL, Rose LI (1991) Etidronate for hypercalcemia of malignancy and osteoporosis. Am Fam Physician 43:2155–2159 Google Scholar 18. Hughes TE, Hansen LA (1992) Gallium nitrate. Ann Pharmacother 26:354–362 Google Scholar 19. [link.springer.com]

  But steroids can somtimes increase the risk of osteoporosis and the breakdown of bone. Using dialysis for people with kidney failure. Dialysis is a mechanized filtering process that removes excess waste from the blood. [cancer.net]

• Bone Pain

  Abstract Bisphosphonates have become standard treatment in management of malignancy-induced hypercalcemia and malignant bone pain. [ncbi.nlm.nih.gov]

  pain and weakness irregular heart beat difficulty thinking and speaking clearly It might also lead to coma and eventually death if not treated. [cancerresearchuk.org]

  pain or bone fracture Report symptoms to your doctor or healthcare team as soon as possible. [cancer.ca]

  Bone pain can occur in patients with hyperparathyroidism or malignancy. [aafp.org]

• Muscle Weakness

  Those with moderate hypercalcemia (12 to 14 mg/d) can develop polydipsia, polyuria, clinical dehydration, muscle weakness, and changes in mental status. Those with severe hypercalcemia can develop severe form of these symptoms. [advancedpractitioner.com]

  Neuromuscular effects include impaired concentration, confusion, corneal calcification, fatigue, and muscle weakness. 8 Nausea, abdominal pain, anorexia, constipation, and, rarely, peptic ulcer disease or pancreatitis are among the gastrointestinal manifestations [aafp.org]

  Symptoms of hypercalcemia include: nausea vomiting loss of appetite, or anorexia constipation fatigue muscle weakness increased thirst frequent and increased urination dark yellow urine little or no sweating abnormal heart rhythm weaker muscle reflexes [cancer.ca]

  Abnormally high level of calcium in the blood; manifestations include fatigability, muscle weakness, depression, anorexia, nausea, and constipation. High level of calcium in the blood Higher than normal levels of calcium in the blood. [icd10data.com]

  Most commonly reported adverse reactions are renal toxicity, flu-like symptoms, injection site reactions, hypocalcemia, hypophosphatemia, fatigue, muscle weakness, and constipation of diarrhea. [oatext.com]

• Delusion

  Symptoms include central nervous system impairment such as as delirium with prominent symptoms of personality change, cognitive dysfunction, disorientation, incoherent speech, and psychotic symptoms such as hallucinations and delusions, smooth muscle [fpnotebook.com]

• Polyuria

  A comparison of plasma vasopressin measurements with a standard indirect test in the differential diagnosis of polyuria. N Engl J Med 1981; 305: 1539-46. ‎ [books.google.ro]

  Those with moderate hypercalcemia (12 to 14 mg/d) can develop polydipsia, polyuria, clinical dehydration, muscle weakness, and changes in mental status. Those with severe hypercalcemia can develop severe form of these symptoms. [advancedpractitioner.com]

  The administration of both has been shown to cause a metabolic alkalosis and hypokalemia with polyuria. [karger.com]

  Since some tumor cells can resorb or destroy bone directly, hypercalcemia develops more rapidly and more aggressively than other causes of hypercalcemia, along with classic symptoms of dehydration, anorexia, nausea/vomiting, constipation, and polyuria [oatext.com]

  Therapy with bisphosphonates can serve a palliative purpose for patients with hypercalcemia of malignancy, providing some improvement in polyuria and polydypsia, central nervous system symptoms, constipation, nausea, vomiting, anorexia and malaise, according [acphospitalist.org]

• Nocturia

  The clinical manifestations of hypercalcemia include: Central nervous system effects include lethargy, impaired concentration, fatigue, and muscle weakness; Renal effects include dehydration, polyuria, nocturia, nephrolithiasis resulting from hypercalciuria [oatext.com]

• Altered Mental Status

  Complete Peer review History: http://www.sciencedomain.org/review-history/5350 Abstracts Hypercalcemia in malignancy can present with metabolic derangement, generalized weakness, altered mental status, renal compromise, cardiac dysrhythmias including [sciencedomain.org]

  Patients receiving gallium have reported nausea, vomiting, lethargy, altered mental status, and both diarrhea and constipation. Calcitonin Calcitonin is a peptide hormone secreted by the parafollicular C cells of the thyroid gland. [cjasn.asnjournals.org]

• Stupor

  […] subperiosteal resorption, bone cysts) Gastrointestinal “abdominal moans” Nausea, vomiting Anorexia, weight loss Constipation Abdominal pain Pancreatitis Peptic ulcer disease Neuromuscular “psychic groans” Impaired concentration and memory Confusion, stupor [aafp.org]

  Further elevations can result in more severe symptoms, including weakness, difficulty concentrating, confusion, stupor, and coma. 18 HCM usually is rapidly progressive; therefore, the presence of rapidly rising calcium levels should signal the possibility [uspharmacist.com]

• Asthenia

  Adverse Reactions The most common adverse reactions in patients receiving XGEVA ® with bone metastasis from solid tumors were fatigue/asthenia, hypophosphatemia, and nausea. The most common serious adverse reaction was dyspnea. [xgeva.com]

• Difficulty Concentrating

  Further elevations can result in more severe symptoms, including weakness, difficulty concentrating, confusion, stupor, and coma. 18 HCM usually is rapidly progressive; therefore, the presence of rapidly rising calcium levels should signal the possibility [uspharmacist.com]

A thorough workup ruled out bone metastasis and confirmed increased parathyroid-related protein, the hallmark of HHM. After regaining consciousness, the patient refused further therapy and subsequently died. [ncbi.nlm.nih.gov]

Approximately 50% of calcium is bound to protein, primarily albumin, and the remaining 50% is ionized and is in physiologic active form. [5] Workup When calcium levels are reported as abnormal, the first step is to measure the albumin level. [emedicine.medscape.com]

Further workup for the etiology of his hypercalcemia revealed an appropriately suppressed, intact PTH and normal 25 (OH) Vitamin D and 1,25 (OH)2 Vitamin D levels. [the-hospitalist.org]

The workup to elucidate the etiology of his hypercalcemia revealed his intact PTH level to be appropriately suppressed to 0.95 pmol/l (normal range: 1.06-6.9 pmol/l) and his PTH-related peptide level to be 27 ng/l (normal range: 14-27 ng/l). 25-hydroxy [karger.com]

After an extensive workup, the patient was found to have lymphoma, which was causing hypercalcemia and suppressing PTH. The authors also review the literature on hypercalcemia of malignancy. [jaoa.org]

Abstract Treatment of hypercalcemia of malignancy (HCM) is briefly reviewed, available treatments are compared, and treatment guidelines are presented. The most effective strategy is treatment of the underlying malignancy. [ncbi.nlm.nih.gov]

CONCLUSIONS: The plasma PTH-rp levels may help to predict the calcium-lowering effect of bisphosphonate and give an indication of the prognosis in patients with HM. [ncbi.nlm.nih.gov]

The development of this malignancy complication often purports a poor prognosis. Thorough evaluation to establish the cause of hypercalcemia is essential because some patients may actually have undiagnosed primary hyperparathyroidism. [journals.lww.com]

In general, hypercalcemia of malignancy portends a poor prognosis, and there are three main mechanisms by which hypercalcemia can occur: 1. [renalfellow.blogspot.com]

Abstract The etiology, pathophysiology, and diagnosis of hypercalcemia associated with malignant diseases are discussed. [ncbi.nlm.nih.gov]

More broadly, the poster will include an overview of the presentation, etiology, therapeutic options, and practical considerations in managing this important oncologic syndrome. [advancedpractitioner.com]

The pathophysiological, epidemiological and clinical aspects of hypercalcemia of malignancy are presented in this issue, with a focus on the recently discovered humoral factor responsible for the development of hypercalcemia. [books.google.com]

Obstetrics and Gynecology, Columbia University, New York, USA. 2 b Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, New York, USA. 3 c New York Presbyterian Hospital, New York, USA. 4 d Department of Epidemiology [ncbi.nlm.nih.gov]

Summary Epidemiology Prevalence is unknown. [orpha.net]

Epidemiology Hypercalcaemia is an uncommon problem. Primary hyperparathyroidism is the most common cause. It affects mainly postmenopausal women [ 5 ]. The incidence rate in the UK is 30 per 100,000 [ 6 ]. [patient.info]

Epidemiology and etiology The most common causes of hypercalcemia in the United States are primary hyperthyroidism and malignancy. [oatext.com]

The pathophysiological, epidemiological and clinical aspects of hypercalcemia of malignancy are presented in this issue, with a focus on the recently discovered humoral factor responsible for the development of hypercalcemia. [books.google.com]

Some studies suggest that enhanced renal calcium reabsorption, which plays an important pathophysiological role in the hypercalcemia occurring in primary hyperparathyroidism, is also important pathophysiologically in HHM. [ncbi.nlm.nih.gov]

Abstract Ibandronate is an experimental intravenous bisphosphonate under study for the prevention or treatment of osteoporosis and skeletal complications of bone metastases, as well as hypercalcemia of malignancy. [ncbi.nlm.nih.gov]

Pitfalls, prevention, and treatment of hyperuricemia during tumor lysis syndrome in the era of rasburicase (recombinant urate oxidase). Biologics. 2008;2:129-141. 13. Tufan A, Unal N, Koca E, et al. [uspharmacist.com]

Preventing hypercalcemia The following tips may help keep hypercalcemia from getting worse: Drink fluids Control nausea and vomiting Walk and be active, which helps prevent bone from breaking down Check with your doctor before taking any medications, [cancer.net]