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Hypercalcemia

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https://www.readbyqxmd.com/read/28814738/identification-of-novel-non-secosteroidal-vitamin-d-receptor-agonists-with-potent-cardioprotective-effects-and%C3%A2-%C3%AF-%C3%AF-devoid-of-hypercalcemia
#1
Santosh A Khedkar, Mohammed A Samad, Sangita Choudhury, Ji Yoo Lee, Dongsheng Zhang, Ravi I Thadhani, S Ananth Karumanchi, Alan C Rigby, Peter M Kang
Vitamin D regulates many biological processes, but its clinical utility is limited by its hypercalcemic effect. Using a virtual screening platform to search novel chemical probes that activate the vitamin D signaling, we report discovery of novel non-steroidal small-molecule compounds that activate the vitamin D receptor (VDR), but are devoid of hypercalcemia. A lead compound (known as VDR 4-1) demonstrated potent transcriptional activities in a VDR reporter gene assay, and significantly ameliorated cardiac hypertrophy in cell culture studies and in animal models...
August 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28808512/a-case-of-hypercalcemia-with-double-pathology
#2
Ahmed Abdalla, Ghassan Bachuwa, Samer Al Hadidi
Hypercalcemia has many causes including primary hyperparathyroidism, malignancy, and other rare etiologies. In most of the cases, hypercalcemia is secondary to one etiology. In this case, we are reporting hypercalcemia with two causes. The initial workup showed primary hyperparathyroidism due to parathyroid adenoma. But because all features were not fully explained by primary hyperparathyroidism, further work-up revealed multiple myeloma. This case represents coexistence of two different diseases, which was rarely reported in the literature previously...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28806048/electrolytes-calcium-disorders
#3
Craig Barstow
A normal serum calcium level is 8 to 10 mg/dL. The diagnosis of hypercalcemia (ie, levels 10.5 mg/dL or greater) should be confirmed with an albumin-adjusted or ionized calcium level. The two most common causes of hypercalcemia are hyperparathyroidism and malignancy. Drugs, notably lithium and thiazide diuretics, also can cause hypercalcemia. Patients with severe or symptomatic hypercalcemia should be treated initially with hydration to decrease calcium levels. The evaluation should include a parathyroid hormone (PTH) level...
August 2017: FP Essentials
https://www.readbyqxmd.com/read/28801091/how-much-is-too-much-two-contrasting-cases-of-excessive-vitamin-d-supplementation
#4
Sollip Kim, Laura D Stephens, Robert L Fitzgerald
BACKGROUND: In this report, we describe 2 contrasting cases of hypervitaminosis D. CASE PRESENTATION: Patient 1 was a 75-y old man who developed symptomatic hypercalcemia (peak serum calcium concentration of 15.3mg/dl; reference range: 8.5-10.6mg/dl), cardiac injury, and a high total serum vitamin D concentration of 243ng/ml (30-80ng/ml) as a result of daily consumption of prescribed 50,000IU ergocalciferol (vitamin D2) and 500mg calcium-citrate for 1y. Patient 2 was a 60-y old woman who consumed 40,000IU of cholecalciferol (vitamin D3) daily for >10months with a peak total serum vitamin D concentration of 479ng/ml (30-80ng/ml), but did not present with symptoms related to vitamin D toxicity...
August 8, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28798774/multiple-osteolytic-lesions-causing-hypercalcemia-a-rare-presentation-of-acute-lymphoblastic-leukemia
#5
Khalid Mahmood, Muhammad Ubaid, Syeda Taliya Rizvi
Acute lymphoblastic leukemia is characterized by unchecked proliferation of malignant lymphoblasts which replaces the normal bone marrow culminating in anemia due to red blood cells inadequacy as well as in easy bruising/bleeding secondary to insufficient platelets production. Even the white blood cells which are produced excessively are immature and abnormal. ALL is the most common hematological malignancy in children. Most commonly, patients present with lymphadenopathy, recurrent infections, bleeding, fatigue, and bone pains...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28796047/effects-of-calcium-on-the-incidence-of-recurrent-colorectal-adenomas-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#6
Sajesh K Veettil, Siew Mooi Ching, Kean Ghee Lim, Surasak Saokaew, Pochamana Phisalprapa, Nathorn Chaiyakunapruk
BACKGROUND: Protective effects of calcium supplementation against colorectal adenomas have been documented in systematic reviews; however, the results have not been conclusive. Our objective was to update and systematically evaluate the evidence for calcium supplementation taking into consideration the risks of systematic and random error and to GRADE the evidence. METHODS: The study comprised a systematic review with meta-analysis and trial sequential analysis (TSA) of randomized controlled trials (RCTs)...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28792693/serum-hepcidin-levels-in-multiple-myeloma
#7
Manolov Victor, Hadjiev Evgeniy, Tzvetkova Gergana, Petrova Julia, Vasilev Vasil, Marinov Borislav, Bogov Ivo, Gramatikova Zlatina, Tzatchev Kamen
BACKGROUND: Multiple myeloma (MM) is a malignant disease with a 10% frequency among all haematology neoplasms. It is characterized by clone proliferation of plasmatic cells in bone marrow, monoclonal gammopathy, and anemia, hypercalcemia, and kidney failure and bone lesions. IL-6 is an inflammatory cytokine, potential growth factor for myeloma cells, as elevated serum levels are connected with poor disease prognosis. IL-6 modulates many gene transcriptions, encoding synthesis of acute phase proteins, including C-reactive protein (CRP) and hepcidin...
July 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28781829/an-acute-phase-reaction-with-intravenous-bisphosphonate-use-in-a-patient-with-recently-diagnosed-graves-disease
#8
Katharine Gupta, Jane Estrella, Rohit Rajagopal, Praseetha Shanmugalingam, David Simmons
Given the immune background, we hypothesize that active Grave's hyperthyroidism is a risk factor for an acute phase reaction associated with the use of bisphosphonates. We recommend that in patients with Graves' thyrotoxicosis and hypercalcemia, consider the risk of an acute phase reaction if planning to give bisphosphonate therapy.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28781308/systemic-sarcoidosis-with-thyroid-involvement
#9
Hideyuki Okuma, Koshi Hashimoto, Xin Wang, Noriaki Ohkiba, Nozomi Murooka, Norikazu Akizuki, Takeshi Inazawa, Yoshihiro Ogawa
A 66-year-old woman, who was diagnosed with iritis, visited our hospital due to general malaise. A blood analysis revealed hypercalcemia. Computed tomography revealed mediastinal and hilar lymph node hyperplasia. Moreover, (67)Gallium scintigraphy demonstrated strong accumulation in the lesions, suggesting sarcoidosis. A core needle biopsy (CNB) of the hypoechoic areas of the thyroid was performed because the patient refused to undergo a bronchoscopic examination. The scattering of slightly acidophilic epithelioid cell granulomas was observed in the pathological examination of the biopsy specimen...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28770447/the-effect-of-primary-hyperparathyroidism-on-pancreatic-exocrine-function
#10
P Sisman, M Avci, A Akkurt, A B Sahin, O O Gul, C Ersoy, E Erturk
BACKGROUND: Elastase-1 is a proteolytic enzyme secreted by pancreatic acinar cells, and measurements of the concentration this enzyme are used to evaluate pancreatic exocrine function. We aimed to determine whether pancreatic exocrine function declines due to chronic hypercalcemia by measuring fecal elastase levels. METHODS: 75 patients with primary hyperparathyroidism (18 men and 47 women) and 30 healthy subjects (11 men and 19 women) participated in this study...
August 2, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28768698/the-future-advances-in-therapeutic-approach-and-management-strategies-for-men1
#11
Rachel S van Leeuwaarde, Joanne M de Laat, Carolina R C Pieterman, Koen M A Dreijerink, Menno Vriens, Gerlof D Valk
Multiple endocrine neoplasia type 1 is a rare autosomal inherited disorder associated with a high risk for patients to simultaneously develop tumours of the parathyroid glands, duodeno-pancreatic neuroendocrine tumors and tumors of the anterior pituitary gland. Early identification of MEN1 in patients enables presymptomatic screening of manifestations which makes timely interventions possible with the intention to prevent morbidity and mortality. Causes of death nowadays have shifted towards local or metastatic progression of malignant neuro endocrine tumors...
August 2, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28766002/similar-survival-outcomes-in-patients-with-biclonal-versus-monoclonal-myeloma-a-multi-institutional-matched-case-control-study
#12
Artur Jurczyszyn, Alessandro Gozzetti, Joanna Gdula-Argasińska, Jacek Czepiel, Ravi Vij, Mark Fiala, Davila Julio Valls, Krzysztof Mądry, Anna Waszczuk-Gajda, Sebastian Grosicki, Agnieszka Barchnicka, Edvan Crusoe, Vania Hungria, Massimo Gentile, Giuseppe Mele, Marcin Ksieniewicz, David H Vesole, Jorge J Castillo
Multiple myeloma is a plasma cell malignancy characterized by clonal proliferation of plasma cells in the bone marrow and associated organ damage. Usually, patients with myeloma present with a single monoclonal protein in serum and/or urine constituted by one heavy chain and one light chain. In less than 5% of the patients, more than one monoclonal protein can be identified. The aim of our retrospective multicenter matched case-control study was to describe the characteristics of cases with biclonal myeloma and compare them against a control group of monoclonal myeloma patients matched by age, sex, and year of diagnosis...
August 1, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28761894/gastric-pneumatosis-from-isolated-gastric-calciphylaxis
#13
Aditi Mulgund, Sanam Razeghi, Sampath Poreddy
A 58-year-old man with end-stage renal disease presented with hypotension and emesis, pale conjunctivae, and a distended abdomen. Labs revealed hypercalcemia and leukocytosis. Abdominal imaging showed gastric pneumatosis. Endoscopy demonstrated significant hemorrhage and necrosis in the gastric cardia and fundus. Biopsies revealed acute ulcerative gastritis and focal intravascular calcium phosphate crystals. The patient remained nil per os and was placed on omeprazole and sucralfate. Repeat endoscopy demonstrated mucosal healing...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28761239/sequential-autologous-hematopoietic-stem-cell-transplant-followed-by-renal-transplant-in-multiple-myeloma
#14
D Bhowmik, S Yadav, L Kumar, S Agarwal, S K Agarwal, S Gupta
A 30-year-old female was symptomatic with headache, fatigue, and weakness since October 2011 and was told to have anemia. In January 2012, she was admitted outside with pulmonary edema. Investigations revealed advanced azotemia, anemia, and hypercalcemia. Urine showed 2 + proteins and 30-35 red blood cells. There was no history of oral ulcers, rash, Raynaud's phenomenon, or hemoptysis. She was evaluated for causes of rapidly progressive "renal failure." Hemolytic work-up; antinuclear antibody, double-stranded DNA, and anti-neutrophil cytoplasmic antibody were negative...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28751994/hypercalcemia-in-lung-cancer-due-to-simultaneously-elevated-pthrp-and-ectopic-calcitriol-production-first-case-report
#15
Saed Nemr, Sunitha Alluri, Dhivya Sundaramurthy, Daniel Landry, Gregory Braden
Calcitriol-mediated hypercalcemia has been reported in malignant lymphomas and granulomatous diseases but not in lung carcinoma. We describe a patient with squamous cell lung carcinoma with hypercalcemia and elevated calcitriol levels. A 60-year-old Caucasian male patient with stage IIIB squamous cell lung cancer developed hypercalcemia at 14.8 mg/dL two years after receiving chemotherapy and radiotherapy where labs showed a serum intact PTH: 7 pg/mL, PTHrP: 30 pmol/L, 1,25-hydroxyvitamin D (calcitriol): 76 pg/mL, and 25-hydroxyvitamin D levels: <4 ng/mL...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28748897/milk-alkali-syndrome-induced-by-h1n1-influenza-vaccine
#16
Abdullah K Al-Hwiesh, Ibrahiem Saeed Abdul-Rahman, Nadia Al-Oudah, Sana Al-Solami, Fahd A Al-Muhanna
Milk-Alkali syndrome (MAS) consists of a triad of hypercalcemia, metabolic alkalosis, and acute renal failure. We hereby report a 75-year-old Indian gentleman who presented to our emergency department with a history of generalized weakness and easy fatigability. Investigations were consistent with MAS secondary to calcium carbonate and calcitriol treatment to prevent osteoporosis, aggravated by H1N1 influenza vaccine. The patient was treated with hemodialysis and zoledronate. To our knowledge, this is the first reported case of such association in the literature...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748250/-disseminated-osteolytic-lesions-in-a-28-year-old-refugee
#17
T Karrasch, H D Walmrath, M Kampschulte, D Steiner, W Seeger, W Padberg, U Sibelius, S Gattenlöhner, A Schäffler
A 28-year-old Syrian refugee presented with right-sided knee pain and progressive deterioration of the general condition over the past months. Laboratory diagnostics revealed severe hypercalcemia due to primary hyperparathyroidism, and computed tomography (CT) scanning demonstrated disseminated osteolytic lesions throughout the skeleton. Histologically, these lesions were characterized by multinuclear giant cells (defining these lesions as so-called brown tumors). Finally, surgical removal of a jugular mass allowed the histopathologic diagnosis of a sporadic parathyroid carcinoma...
July 26, 2017: Der Internist
https://www.readbyqxmd.com/read/28748100/a-case-of-hypercalcaemia-in-an-immunocompetent-patient-with-mycobacterium-avium-intracellulare
#18
Christine E Parsons, Sujata Singh, Holly L Geyer
Mycobacterium avium intracellulare infection or colonization should be considered in the differential diagnosis of hypercalcemia, especially in immunocompromised individuals, in the appropriate clinical context.
July 2017: JRSM Open
https://www.readbyqxmd.com/read/28746917/cytological-features-of-the-large-cell-variant-of-small-cell-ovarian-carcinoma-in-young-patients-with-hypercalcemia-histological-findings-and-review-of-the-literature
#19
Helen J Trichia, Paraskevi Tziakou, Dimitrios C Papatheodorou, Joanna Lekka
OBJECTIVE: To present the cytological features of a very rare and lethal ovarian neoplasm occurring in the young. STUDY DESIGN: We reviewed the cytological findings as they presented in touch imprints obtained from an ovarian mass sent to our department for frozen section investigation. RESULTS: Smears were highly cellular. The cells were of intermediate size with a moderate amount of microvacuolated, pale, or eosinophilic cytoplasm with indistinct cell borders...
July 27, 2017: Acta Cytologica
https://www.readbyqxmd.com/read/28746021/use-of-a-technetium99m-sestamibi-scan-to-detect-ipsilateral-double-adenoma-in-a-patient-with-primary-hyperparathyroidism-a-case-report
#20
Joseph Gabriel Gabriel, Alejandro Contreras, Andrew Rosenthal
INTRODUCTION: Patients with primary hyperparathyroidism generally have a single parathyroid adenoma that causes excessive excretion of parathyroid hormone. For about 2% to 15% of these patients, a double adenoma is present that involves one lesion on each side of the neck. CASE PRESENTATION: We describe a case of double parathyroid adenoma causing asymptomatic hypercalcemia. A presurgical technetium99m (Tc99m) sestamibi scan suggested an ipsilateral double adenoma in the left thyroid lobe...
2017: Permanente Journal
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