Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 13.337
Filtrar
1.
Vet Clin North Am Small Anim Pract ; 52(6): 1283-1303, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36336421

RESUMO

Canine schistosomiasis is a well-established cause of a granulomatous enteropathy and hepatopathy in dogs. In a small subset of patients, infection triggers significant hypercalcemia. Clinical signs and clinicopathologic findings are fairly nonspecific but ultrasonographic evidence of heterogenous small intestinal wall layering and pin-point hyperechoic foci in bowel, nodes, and liver is highly suggestive of infection. A sensitive, commercially available, fecal polymerase chain reaction test can be used to establish the diagnosis. Treatment protocols rely on praziquantel with fenbendazole. Most dogs will recover, although retreatment may be necessary in a substantial proportion. Housemates should be screened as infection can be asymptomatic.


Assuntos
Doenças do Cão , Hipercalcemia , Esquistossomose , Cães , Animais , Estados Unidos/epidemiologia , Doenças do Cão/diagnóstico , Doenças do Cão/tratamento farmacológico , Doenças do Cão/patologia , Esquistossomose/complicações , Esquistossomose/diagnóstico , Esquistossomose/veterinária , Fenbendazol/uso terapêutico , Hipercalcemia/veterinária , Fígado
2.
Probl Endokrinol (Mosk) ; 68(5): 24-31, 2022 Jun 17.
Artigo em Russo | MEDLINE | ID: mdl-36337015

RESUMO

Hypocalciuric hypercalcemia syndrome (familial hypocalciuric hypercalcemia, FHH) is an inherited condition based on dysfunction of the calcium receptor or its associated partner proteins. Recent evidence suggests that the prevalence of this condition may be comparable to that of primary hyperparathyroidism. Clinical manifestations of FHH are usually absent; however the classic symptoms of hypercalcemia may be present in some cases. Timely differential diagnosis of FHH avoids unnecessary and expensive instrumental examination, as well as ineffective treatment. The clinical cases presented in this publication demonstrate the unjustified difficulties in this issue and the necessity to raise the awareness of physicians about the familial hypocalciuric hypercalcemia.


Assuntos
Hipercalcemia , Hiperparatireoidismo , Nefropatias , Humanos , Hipercalcemia/diagnóstico , Receptores de Detecção de Cálcio , Síndrome , Instituições de Assistência Ambulatorial
3.
Medicine (Baltimore) ; 101(46): e31750, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36401406

RESUMO

BACKGROUND: Most patients with parathyroid adenomas are asymptomatic and rarely present with chronic pancreatitis (CP). Several studies have reported a positive association between primary hyperparathyroidism (PHPT) and pancreatitis. Parathyroidectomy is the definitive treatment for PHPT. IV bisphosphonates can be considered the drug of choice for bridge to surgery. METHODS: We reported a 57-year-old female patient was admitted to the emergency room with left upper quadrant abdominal pain and a diagnosis of recurrent pancreatitis. Magnetic Resonance Cholangiopancreatography confirmed the diagnosis of CP. The patient had no common etiology of pancreatitis. Persistent hypercalcemia was noted despite administering intravenous fluids, and Calcitonin. Intravenous Pamidronate, a Bisphosphonate derivative, was also administered. Although calcium levels initially decreased, they were later found to rebound to previous levels. RESULTS: A diagnosis of parathyroid adenoma and PHPT was made based on the elevated parathyroid hormone levels and cervical ultrasonography indicated right inferior parathyroid adenoma. Technetium-99m methoxy-isobutyl-isonitrile scintigraphy revealed a focal hot spot of tracer accumulation at the right lower thyroid bed. The patient underwent right lower parathyroidectomy smoothly and successfully. After right lower parathyroidectomy, she had normal serum calcium levels (9.2 mg/dL) and parathyroid hormone (16.1 pg/mL). There was no recurrent abdominal pain after the operation. CONCLUSION: CP is a rare manifestation of parathyroid adenoma. When patients with a history of recurrent pancreatitis, without common causes of pancreatitis, present persistent elevated serum calcium levels, PHPT could be suspected.


Assuntos
Hipercalcemia , Pancreatite Crônica , Neoplasias das Paratireoides , Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/cirurgia , Cálcio , Hipercalcemia/diagnóstico , Hormônio Paratireóideo , Dor Abdominal/etiologia
4.
Rinsho Ketsueki ; 63(10): 1373-1378, 2022.
Artigo em Japonês | MEDLINE | ID: mdl-36351642

RESUMO

We here present a 33-year-old woman who was referred to our hospital with a complaint of back pain and was found to have elevated IgG and hypercalcemia, as well as osteolytic lesions of pelvis and spines. 18F-FDG-PET/CT scan revealed numerous uptakes in the bones. An examination of the bone marrow revealed increased plasma cells (10.2%). Despite clinical similarities to multiple myeloma, any evidence of plasma cell clonal proliferation, including serum M-protein and light chain restriction, was not found. A reexamination of the bone marrow with a biopsy revealed the proliferation of abnormal cells with chromogranin A and synaptophysin expression but no expression of hematopoietic and epithelial cell markers. Based on these results together with extra-adrenal lesions, a diagnosis of malignant paraganglioma was made. Malignant paraganglioma is known to frequently cause bone metastasis and skeletal related events, whose clinical manifestations are similar to those of multiple myeloma. Since patients with osteolytic lesions, hypercalcemia, and hypergammaglobulinemia are likely to be referred to hematologists, malignant paraganglioma should be considered as a differential diagnosis.


Assuntos
Hipercalcemia , Mieloma Múltiplo , Paraganglioma , Feminino , Humanos , Adulto , Mieloma Múltiplo/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Fluordesoxiglucose F18/metabolismo , Paraganglioma/diagnóstico
5.
Sci Rep ; 12(1): 19191, 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36357446

RESUMO

Our aim was to identify and quantify high coronary artery calcium (CAC) with deep learning (DL)-powered CAC scoring (CACS) in oncological patients with known very high CAC (≥ 1000) undergoing 18F-FDG-PET/CT for re-/staging. 100 patients were enrolled: 50 patients with Agatston scores ≥ 1000 (high CACS group), 50 patients with Agatston scores < 1000 (negative control group). All patients underwent oncological 18F-FDG-PET/CT and cardiac SPECT myocardial perfusion imaging (MPI) by 99mTc-tetrofosmin within 6 months. CACS was manually performed on dedicated non-contrast ECG-gated CT scans obtained from SPECT-MPI (reference standard). Additionally, CACS was performed fully automatically with a user-independent DL-CACS tool on non-contrast, free-breathing, non-gated CT scans from 18F-FDG-PET/CT examinations. Image quality and noise of CT scans was assessed. Agatston scores obtained by manual CACS and DL tool were compared. The high CACS group had Agatston scores of 2200 ± 1620 (reference standard) and 1300 ± 1011 (DL tool, average underestimation of 38.6 ± 26%) with an intraclass correlation of 0.714 (95% CI 0.546, 0.827). Sufficient image quality significantly improved the DL tool's capability of correctly assigning Agatston scores ≥ 1000 (p = 0.01). In the control group, the DL tool correctly assigned Agatston scores < 1000 in all cases. In conclusion, DL-based CACS performed on non-contrast free-breathing, non-gated CT scans from 18F-FDG-PET/CT examinations of patients with known very high (≥ 1000) CAC underestimates CAC load, but correctly assigns an Agatston scores ≥ 1000 in over 70% of cases, provided sufficient CT image quality. Subgroup analyses of the control group showed that the DL tool does not generate false-positives.


Assuntos
Doença da Artéria Coronariana , Aprendizado Profundo , Hipercalcemia , Humanos , Vasos Coronários/diagnóstico por imagem , Cálcio , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Doença da Artéria Coronariana/diagnóstico por imagem , Cálcio na Dieta
6.
BMJ Case Rep ; 15(11)2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36379628

RESUMO

A woman in her late 70s presented with an increased frequency of micturition, suprapubic pain and weight loss. She was found to be having advanced cancer of the urinary bladder, coupled with bilateral hydronephrosis.Whilst undergoing surgical intervention for the latter, she was incidentally found to be having hypercalcaemia. This was found to be paraneoplastic in nature, possibly due to elevated parathyroid hormone related peptide with no evidence of bone metastasis. The histology of the resected tumour revealed squamous and sarcomatoid differentiation. Her hypercalcaemia initially responded to intravenous fluids, and later on zolendronate,but the problem recurred again, with the response to a repeat dose of zolendronate and even denosumab being unsatisfactory. As a last resort cinacalcet was started, and although there was a good response to it, our patient sadly died a few weeks later.We believe our case to be the first case of hypercalcaemia associated with isolated bladder cancer which showed a successful response to cinacalcet.


Assuntos
Neoplasias Ósseas , Hipercalcemia , Neoplasias da Bexiga Urinária , Feminino , Humanos , Cinacalcete/uso terapêutico , Hipercalcemia/tratamento farmacológico , Hipercalcemia/etiologia , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Ósseas/secundário , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/tratamento farmacológico , Hormônio Paratireóideo/uso terapêutico
7.
BMJ Case Rep ; 15(11)2022 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-36323452

RESUMO

Humoral hypercalcaemia of malignancy is rarely associated with cutaneous squamous cell carcinoma (SCC), and only a few cases have been reported in the medical literature. We present an interesting case of a gigantic cutaneous SCC associated with severe hypercalcaemia.A man in his mid 80s presented with a rapidly enlarging fungating mass of his scalp for 5 months. Laboratory studies logged severe hypercalcaemia, low intact parathyroid hormone, elevated parathyroid hormone related-peptide and normal 1,25 dihydroxy vitamin D. Skin biopsy revealed moderately differentiated invasive SCC. Further workup was negative for distant skeletal metastases. Severe hypercalcaemia was managed by intravenous fluids, bisphosphonates and calcitonin. A multidisciplinary approach was then made; the patient received radiotherapy and then underwent a successful surgical resection. By presenting this case, we aim to raise physicians' awareness of the association between cutaneous SCC and hypercalcaemia. Severe hypercalcaemia should be detected early and promptly managed as it could be fatal.


Assuntos
Carcinoma de Células Escamosas , Hipercalcemia , Neoplasias Cutâneas , Masculino , Humanos , Hipercalcemia/etiologia , Carcinoma de Células Escamosas/complicações , Neoplasias Cutâneas/complicações , Hormônio Paratireóideo , Difosfonatos/uso terapêutico
8.
Medicine (Baltimore) ; 101(40): e30883, 2022 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-36221396

RESUMO

RATIONALE: There are many causes of hypercalcemia, with hyperparathyroidism and malignancy accounting for 90% of cases. Sarcoidosis and the intake of vitamin D supplements may also cause hypercalcemia, although the occurrence rate is low if only one is involved. We herein report a sarcoidosis patient who developed hypercalcemia after taking cholecalciferol (vitamin D supplement) for a year. PATIENT CONCERN: A 62-year-old Japanese man presented with hypercalcemia and acute kidney injury along with symptoms of fatigue and appetite loss while being followed up for sarcoidosis. DIAGNOSES: We determined that a combination of cholecalciferol supplementation and sarcoidosis had led to hypercalcemia for several reasons. First, hypercalcemia had not been noted when this patient had first been admitted due to sarcoidosis-related respiratory failure several years earlier, which we presumed that was the highest sarcoidosis disease activity. Second, low serum 25-OH Vit.D3 and high 1,25-(OH)2 Vit.D3 levels were noted despite cholecalciferol supplementation for a year, suggesting that 1-α-hydroxylase overexpression caused by sarcoidosis accelerated the conversion from 25-OH Vit.D3 to 1,25-(OH)2 Vit.D3. INTERVENTIONS: Although initially resistant to preservative management, the hypercalcemia promptly improved after starting corticosteroid treatment. OUTCOMES: Hypercalcemia and acute kidney injury were normalized after corticosteroid treatment. LESSONS: We should be aware of patients' medications, especially in patients with granulomatosis disease. The concomitant measurement of 25-OH Vit.D3 and 1,25-(OH)2 Vit.D3 levels is useful for determining the cause of hypercalcemia.


Assuntos
Injúria Renal Aguda , Hipercalcemia , Sarcoidose , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/complicações , Cálcio , Colecalciferol/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Humanos , Hipercalcemia/induzido quimicamente , Hipercalcemia/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Oxigenases de Função Mista , Sarcoidose/complicações , Sarcoidose/tratamento farmacológico , Vitamina D/uso terapêutico
9.
Biomed Res Int ; 2022: 1913900, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36193301

RESUMO

Objective: To review the features and treatment of parathyroid cancer in our series. Explore the suitable extent of initial surgery and the effect of adjuvant radiotherapy in local recurrence. Methods: Seven cases of parathyroid cancer presented from 2014 to 2021. The presenting features, diagnosis, and treatment are presented. Results: Only two patients had multiple manifestations of hypercalcemia. Marked hypercalcemia, which was revealed to be an average of 13.9 mg/dl (range from 11.8 mg/dl to 15.8 mg/dl), was observed in four patients (57%). The others' serum calcium levels were in the normal range with an average of 9.9 mg/dl (range from 8.6 mg/dl to 10.8 mg/dl). All seven patients had hyperparathyroidism with an average of 733 pg/ml (range from 113 pg/ml to 3193 pg/ml). En bloc resection was performed in two patients with neighboring structure invasion, and four patients with complete tumor capsules underwent tumor resection with limited resection of the thyroid gland. Postoperative adjuvant radiotherapy appeared unsuccessful for local recurrence. Conclusion: High calcium, high PTH, parathyroid occupation by ultrasound, and intraoperative invasion should be considered to have the possibility of parathyroid cancer. Open surgery is recommended and protecting tumor integration is the elementary surgery principle. The initial surgical extent should be decided by the invasion of the tumor. When PC has a local recurrence, the debulking surgery and adjuvant radiotherapy are always fake.


Assuntos
Hipercalcemia , Neoplasias das Paratireoides , Cálcio , Cápsulas , Humanos , Hormônio Paratireóideo , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/cirurgia , Estudos Retrospectivos
12.
Endocrinol Diabetes Metab ; 5(6): e380, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36195995

RESUMO

INTRODUCTION: Severe hypercalcaemia is a life-threatening condition that should be managed urgently. The aim of this study was to assess the efficacy of saline hydration, furosemide, and zoledronic acid in the management of severe hypercalcaemia secondary to primary hyperparathyroidism (PHPT). METHODS: We conducted a retrospective analysis of the management of 65 patients with severe hypercalcaemia (≥3 mmol/L) secondary to PHPT. The efficacy of each therapeutic agent was evaluated according to the variation in serum calcium level calculated as Δ calcium = initial calcium level - minimal calcium level reached after the administration of each agent. RESULTS: The mean age of patients was 56.4 ± 13.8 years. At baseline, the mean total serum calcium level was 3.42 ± 0.40 mmol/L. After normal saline hydration, calcium level decreased from 3.25 ± 0.21 to 2.98 ± 0.2 mmol/L (p < 10-3 ) in 3.1 ± 1.7 days. Normalization of calcium level did not occur in any patient. Furosemide was prescribed in 35 patients. It resulted in a serum calcium increase of 0.09 ± 0.21 mmol/L. Calcium levels did not reach the normal range in any patient. Forty-five patients received intravenous zoledronic acid. The mean maximal reduction in serum calcium level was 0.57 ± 0.27 mmol/L (from 3.25 ± 0.26 mmol/L to 2.68 ± 0.22 mmol/L, p-value <10-3 ). Normalization of calcium levels occurred in 27 patients (60%). CONCLUSIONS: Our results show the absence of a significant additional effect of furosemide on calcium levels in patients with severe hypercalcaemia secondary to PHPT when compared with the effect of saline hydration alone. However, zoledronic acid was more potent. Thus, appropriate normal saline hydration with immediate intravenous bisphosphonates infusion should be considered in the management of severe hypercalcaemia in patients with PHPT.


Assuntos
Hipercalcemia , Hiperparatireoidismo Primário , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Hipercalcemia/tratamento farmacológico , Hipercalcemia/etiologia , Furosemida/uso terapêutico , Ácido Zoledrônico/uso terapêutico , Cálcio/uso terapêutico , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/tratamento farmacológico , Estudos Retrospectivos , Solução Salina/uso terapêutico
13.
JAMA ; 328(16): 1624-1636, 2022 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-36282253

RESUMO

Importance: Hypercalcemia affects approximately 1% of the worldwide population. Mild hypercalcemia, defined as total calcium of less than 12 mg/dL (<3 mmol/L) or ionized calcium of 5.6 to 8.0 mg/dL (1.4-2 mmol/L), is usually asymptomatic but may be associated with constitutional symptoms such as fatigue and constipation in approximately 20% of people. Hypercalcemia that is severe, defined as total calcium of 14 mg/dL or greater (>3.5 mmol/L) or ionized calcium of 10 mg/dL or greater (≥2.5 mmol/L) or that develops rapidly over days to weeks, can cause nausea, vomiting, dehydration, confusion, somnolence, and coma. Observations: Approximately 90% of people with hypercalcemia have primary hyperparathyroidism (PHPT) or malignancy. Additional causes of hypercalcemia include granulomatous disease such as sarcoidosis, endocrinopathies such as thyroid disease, immobilization, genetic disorders, and medications such as thiazide diuretics and supplements such as calcium, vitamin D, or vitamin A. Hypercalcemia has been associated with sodium-glucose cotransporter 2 protein inhibitors, immune checkpoint inhibitors, denosumab discontinuation, SARS-CoV-2, ketogenic diets, and extreme exercise, but these account for less than 1% of causes. Serum intact parathyroid hormone (PTH), the most important initial test to evaluate hypercalcemia, distinguishes PTH-dependent from PTH-independent causes. In a patient with hypercalcemia, an elevated or normal PTH concentration is consistent with PHPT, while a suppressed PTH level (<20 pg/mL depending on assay) indicates another cause. Mild hypercalcemia usually does not need acute intervention. If due to PHPT, parathyroidectomy may be considered depending on age, serum calcium level, and kidney or skeletal involvement. In patients older than 50 years with serum calcium levels less than 1 mg above the upper normal limit and no evidence of skeletal or kidney disease, observation may be appropriate. Initial therapy of symptomatic or severe hypercalcemia consists of hydration and intravenous bisphosphonates, such as zoledronic acid or pamidronate. In patients with kidney failure, denosumab and dialysis may be indicated. Glucocorticoids may be used as primary treatment when hypercalcemia is due to excessive intestinal calcium absorption (vitamin D intoxication, granulomatous disorders, some lymphomas). Treatment reduces serum calcium and improves symptoms, at least transiently. The underlying cause of hypercalcemia should be identified and treated. The prognosis for asymptomatic PHPT is excellent with either medical or surgical management. Hypercalcemia of malignancy is associated with poor survival. Conclusions and Relevance: Mild hypercalcemia is typically asymptomatic, while severe hypercalcemia is associated with nausea, vomiting, dehydration, confusion, somnolence, and coma. Asymptomatic hypercalcemia due to primary hyperparathyroidism is managed with parathyroidectomy or observation with monitoring, while severe hypercalcemia is typically treated with hydration and intravenous bisphosphonates.


Assuntos
Hipercalcemia , Hiperparatireoidismo Primário , Hormônio Paratireóideo , Humanos , Cálcio/sangue , Coma/etiologia , COVID-19/complicações , Desidratação/etiologia , Desidratação/terapia , Denosumab/efeitos adversos , Hipercalcemia/sangue , Hipercalcemia/etiologia , Hipercalcemia/terapia , Hiperparatireoidismo Primário/sangue , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/diagnóstico , Hiperparatireoidismo Primário/terapia , Inibidores de Checkpoint Imunológico/efeitos adversos , Náusea/etiologia , Neoplasias/sangue , Neoplasias/complicações , Pamidronato/uso terapêutico , Hormônio Paratireóideo/sangue , SARS-CoV-2 , Sonolência , Inibidores de Simportadores de Cloreto de Sódio/efeitos adversos , Vitamina A/efeitos adversos , Vitamina D/efeitos adversos , Vômito/etiologia , Ácido Zoledrônico/uso terapêutico
14.
BMC Endocr Disord ; 22(1): 259, 2022 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-36284286

RESUMO

BACKGROUND: Parathyroid carcinoma is an uncommon cause of PTH-dependent hypercalcemia. Only a handful of cases have been reported of parathyroid carcinoma during pregnancy. CASE PRESENTATION: Twenty-four - Year - old female presented with proximal myopathy was found to have hypercalcemia. Her serum corrected total calcium was - 15 mg/dl (8.5 - 10.3), serum phosphate - 2.3 mg/dl (2.5 - 4.5), intact PTH - 118 pg/ml (20 - 80), Vitamin D - 15 ng/ml and Urine Ca/Cr ratio - 2.1 (0.1 - 0.2). Her CECT-neck revealed a well-defined mass lesion posterior to the right lobe of the thyroid - 2.6 cm × 2.5 cm × 2.9 cm in size. She was started on vitamin D supplementation, and she underwent right lower focal parathyroidectomy. Her PTH levels normalized following surgery. Her histology revealed an atypical parathyroid adenoma. She was treated with calcium and vitamin D. Her follow up was uneventful. One year following initial surgery the patient became pregnant and at 16 weeks of POA, the patient presented with a rapidly enhancing neck mass for one week duration. Her biochemical investigations were suggestive of a recurrence of primary hyperparathyroidism. Her ultrasound scan of the neck revealed a well-defined discreate hypoechoic nodule, superior to the thyroid isthmus which was confirmed by a non-contrast MRI scan of the neck. She underwent an uncomplicated second trimester parathyroid tumour excision with normalization of post op PTH. Her histology revealed a parathyroid carcinoma with vascular and capsular invasion. Her genetic studies revealed a novel frameshift mutation of the CDC73 gene. She was treated with calcium and vitamin D supplementation and closely followed up with ionized calcium and PTH levels which were normal throughout the pregnancy. She had an uncomplicated caesarean section at a POA of 37 weeks. Currently she is twelve weeks post-partum, in remission of disease. CONCLUSION: This case shows the importance of stringent follow up of atypical parathyroid adenoma patients, the benefit of second trimester surgery in management of hypercalcemia due to parathyroid carcinoma during pregnancy and the importance of identifying the novel CDC73 gene mutation.


Assuntos
Adenoma , Hipercalcemia , Neoplasias das Paratireoides , Humanos , Feminino , Gravidez , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/genética , Neoplasias das Paratireoides/patologia , Hipercalcemia/etiologia , Cálcio , Cesárea/efeitos adversos , Hormônio Paratireóideo , Adenoma/complicações , Adenoma/genética , Adenoma/patologia , Vitamina D , Fosfatos , Mutação , Proteínas Supressoras de Tumor/genética
16.
Nutrients ; 14(18)2022 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-36145244

RESUMO

Ovarian cancer is one of the deadliest cancers in women, due to its heterogeneity and usually late diagnosis. The current first-line therapies of debulking surgery and intensive chemotherapy cause debilitating side effects. Therefore, there is an unmet medical need to find new and effective therapies with fewer side effects, or adjuvant therapies, which could reduce the necessary doses of chemotherapeutics. Vitamin D is one of the main regulators of serum calcium and phosphorus homeostasis, but it has also anticancer effects. It induces differentiation and apoptosis, reduces proliferation and metastatic potential of cancer cells. However, doses that would be effective against cancer cause hypercalcemia. For this reason, synthetic and less calcemic analogs have been developed and tested in terms of their anticancer effect. The anticancer role of vitamin D is best understood in colorectal, breast, and prostate cancer and much less research has been done in ovarian cancer. In this review, we thus summarize the studies on the role of vitamin D and its analogs in vitro and in vivo in ovarian cancer models.


Assuntos
Hipercalcemia , Neoplasias Ovarianas , Cálcio , Carcinoma Epitelial do Ovário/tratamento farmacológico , Feminino , Humanos , Masculino , Neoplasias Ovarianas/tratamento farmacológico , Fósforo , Vitamina D/farmacologia , Vitamina D/uso terapêutico , Vitaminas
17.
BMJ Case Rep ; 15(9)2022 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-36167432

RESUMO

Hypercalcaemia is a relatively common metabolic disturbance seen in hospitalised patients; however, given the complicated systems of calcium regulation, it can take a significant amount of time and testing to pinpoint the aetiology. This case discusses a patient who developed acute hypercalcaemia from calcium sulfate-containing antibiotic beads placed during an orthopaedic procedure. These beads are used in surgical procedures to fill gaps/voids in bony structures and for local delivery of antibiotics. The case highlights the importance of careful review of a patient's hospital course, including the administration of medical products that may not be clearly documented on a patient's medicine administration record when working up an unexplained finding.


Assuntos
Sulfato de Cálcio , Hipercalcemia , Antibacterianos/efeitos adversos , Cálcio , Sulfato de Cálcio/efeitos adversos , Sulfato de Cálcio/química , Humanos , Hipercalcemia/induzido quimicamente , Hipercalcemia/tratamento farmacológico
18.
BMC Endocr Disord ; 22(1): 238, 2022 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-36153583

RESUMO

BACKGROUND: Although lithium is considered the gold-standard treatment for bipolar disorder (BD), it is associated with a variety of major endocrine and metabolic side effects, including parathyroid hormone (PTH) dependent hypercalcemia. Aside from surgery and medication discontinuation, there are limited treatments for hypercalcemia. This paper will assess data from a randomized controlled trial (RCT). METHODS: This is a secondary analysis of an RCT that explored the effects of atorvastatin (n = 27) versus placebo (n = 33) on lithium-induced nephrogenic diabetes insipidus (NDI) in patients with BD and major depressive disorder (MDD) using lithium (n = 60), over a 12-week period. This secondary analysis will explore serum calcium levels and thyroid stimulating hormone (TSH) measured at baseline, week 4, and week 12. RESULTS: At 12-weeks follow-up while adjusting results for baseline, linear regression analyses found that corrected serum calcium levels were significantly lower in the treatment group (mean (M) = 2.30 mmol/L, standard deviation (SD) = 0.07) compared to the placebo group (M = 2.33 mmol/L, SD = 0.07) (ß = - 0.03 (95% C.I.; - 0.0662, - 0.0035), p = 0.03) for lithium users. There were no significant changes in TSH. CONCLUSION: In lithium users with relatively normal calcium levels, receiving atorvastatin was associated with a decrease in serum calcium levels. Although exciting, this is a preliminary finding that needs further investigation with hypercalcemic patients. Future RCTs could examine whether atorvastatin can treat PTH dependent hypercalcemia due to lithium and other causes.


Assuntos
Hipercalcemia , Hiperparatireoidismo , Atorvastatina/uso terapêutico , Cálcio , Humanos , Hipercalcemia/induzido quimicamente , Hipercalcemia/complicações , Hipercalcemia/tratamento farmacológico , Hiperparatireoidismo/complicações , Lítio/uso terapêutico , Hormônio Paratireóideo , Tireotropina
19.
Praxis (Bern 1994) ; 111(12): 675-681, 2022 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-36102025

RESUMO

Hypercalcemia - Diagnosis and Management Abstract. The diagnostic workup of hypercalcemia requires a thorough patient history, a focused clinical examination as well as a step-by-step laboratory diagnostic approach. In order to detect the exact aetiology of hypercalcemia an accurate measurement of serum calcium in correlation with the parathyroid hormone level is therefore essential. Primary hyperparathyroidism and malignancy-related hypercalcemia are responsible for about 90% of all hypercalcemia cases. Therefore, these two pathologies should always be considered in the diagnostic approach. The therapeutic procedure is based on the aetiology and severity of the hypercalcemia.


Assuntos
Hipercalcemia , Hiperparatireoidismo , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Hipercalcemia/terapia , Hiperparatireoidismo/complicações , Hiperparatireoidismo/diagnóstico , Hiperparatireoidismo/terapia , Hormônio Paratireóideo
20.
Acta Dermatovenerol Alp Pannonica Adriat ; 31(3): 123-124, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36149043

RESUMO

Scrotal calcinosis is a rare disorder characterized by multiple papules or nodules of calcification in the scrotal skin. The pathogenesis of this disease is poorly understood. The condition presents as several brown to yellowish asymptomatic nodules on the scrotum. Excision followed by scrotal reconstruction is the treatment of choice. It leaves a good cosmetic result with low chances of recurrence. Newer treatments, such as ablative lasers, have been proposed with very good results. We describe the case of a 28-year-old patient with a history of severe acne treated with oral isotretinoin that presented for scrotal nodules. On laboratory examination, hypercalcemia was found with normal phosphorus, parathyroid hormone, and vitamin D hormone levels. Hypercalcemia was linked to his isotretinoin therapy. Serum calcium concentrations normalized after cessation of isotretinoin and hydration. Because the patient refused surgery, a biopsy of the lesion confirmed the diagnosis of scrotal calcinosis. Then the patient was referred to a cosmetic laser center to treat his condition.


Assuntos
Calcinose , Doenças dos Genitais Masculinos , Hipercalcemia , Adulto , Calcinose/induzido quimicamente , Calcinose/diagnóstico , Cálcio , Doenças dos Genitais Masculinos/induzido quimicamente , Doenças dos Genitais Masculinos/diagnóstico , Humanos , Hipercalcemia/patologia , Isotretinoína/efeitos adversos , Masculino , Hormônio Paratireóideo , Fósforo , Escroto/patologia , Escroto/cirurgia , Vitamina D
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...