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1.
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
2.
Am J Case Rep ; 23: e936969, 2022 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36056538

RESUMO

BACKGROUND Milk-alkali syndrome is caused by excessive consumption of calcium and absorbable alkali and typically presents as a triad of hypercalcemia, acute renal failure, and metabolic alkalosis. In the era of histamine receptor blockers and proton pump inhibitors, the incidence of milk-alkali syndrome has decreased. However, the disease has not been eliminated, due to existing calcium-containing therapies. Here, we present a case of severe milk-alkali syndrome with a challenging initial diagnosis. CASE REPORT We present the case of a 64-year-old man who came to the hospital with encephalopathy. Serologic evaluation revealed acute renal failure, severe hypercalcemia, and metabolic alkalosis. He underwent volume resuscitation, with the initiation of calcitonin. Despite our efforts, the patient developed anuria and proceeded to intermittent hemodialysis. His workup was unrevealing, including an appropriately suppressed parathyroid hormone level, low vitamin D, and normal serum protein electrophoresis and angiotensin converting enzyme levels. Considering his persistent encephalopathy, the team was unable to obtain information from the patient regarding his calcium intake. However, at home, the patient's significant other read his progress notes in the electronic medical record and reported that he consumed at least 1 bottle of calcium carbonate (Tums) every week. Once the encephalopathy resolved, the patient confirmed this information. CONCLUSIONS The search for malignancy in the setting of hypercalcemia was ceased because of the family's at-home electronic medical record use and reporting of Tums overuse. Milk-alkali syndrome, although a rarity, should not be forgotten as a cause of hypercalcemia.


Assuntos
Injúria Renal Aguda , Alcalose , Encefalopatias , Hipercalcemia , Neoplasias , Injúria Renal Aguda/etiologia , Alcalose/complicações , Alcalose/etiologia , Cálcio , Carbonato de Cálcio , Registros Eletrônicos de Saúde , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Hipercalcemia/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações
3.
BMJ Case Rep ; 15(8)2022 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-35985738

RESUMO

Hypercalcaemia in patients with hyperthyroidism is usually asymptomatic. It occurs due to increased bone turnover and demineralisation. There are only a few case reports where symptomatic hypercalcaemia was the presenting complaint of hyperthyroidism. An Asian man in his 40s presented to us with intractable vomiting for the last 6 months which was not controlled despite multiple antiemetic medications. On routine biochemistry performed at our institute, he was found to have hypercalcaemia and concomitant hyperthyroidism. Classical symptoms suggestive of hyperthyroidism were not present in our patient thus delaying the diagnosis. His symptoms resolved after the correction of hypercalcaemia. Hypercalcaemia did not recur after achieving an euthyroid status on treatment with carbimazole. Other common and more sinister causes for hypercalcaemia like malignancy were ruled out. This case highlights that symptomatic hypercalcaemia could be the initial presentation of hyperthyroidism and amelioration of hyperthyroidism corrects the hypercalcaemia.


Assuntos
Doença de Graves , Hipercalcemia , Hipertireoidismo , Antitireóideos/uso terapêutico , Carbimazol/uso terapêutico , Doença de Graves/complicações , Doença de Graves/diagnóstico , Doença de Graves/tratamento farmacológico , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/tratamento farmacológico , Hipercalcemia/etiologia , Hipertireoidismo/complicações , Hipertireoidismo/diagnóstico , Hipertireoidismo/tratamento farmacológico , Masculino
4.
BMJ Case Rep ; 15(7)2022 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-35787491

RESUMO

A man in his 50s was admitted with 4 months of myalgia, headaches, hypercalcaemia and declining renal function on a background of lung transplantation for cystic fibrosis 5 years prior. MRI confirmed myositis and a muscle biopsy revealed invasive muscular microsporidial infection. Positron emission tomography(PET)/CT revealed widespread dissemination of the infection. Albendazole was commenced and after a 1 week systemic inflammatory response syndrome, the patient made a significant recovery and was discharged home. PCR testing confirmed the species as Anncaliia algerae, which is known to infect mosquitoes, larvae and contaminate water supplies. This case highlights the need to relentlessly pursue a diagnosis and to consider atypical pathology in immune compromised patients. A tissue sample yielded highly beneficial and unexpected results. A multispecialty approach was essential given the varied infection manifestations, which included myositis, keratitis and possible central nervous system, vocal cord, parapharyngeal and renal involvement.


Assuntos
Fibrose Cística , Hipercalcemia , Ceratite , Miosite , Animais , Humanos , Hipercalcemia/etiologia , Pulmão , Masculino , Miosite/complicações , Miosite/diagnóstico , Tomografia Computadorizada por Raios X , Transplantados
5.
BMJ Case Rep ; 15(7)2022 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-35803612

RESUMO

A woman in her mid-50s with IgA nephropathy, sarcoidosis and steroid-induced diabetes mellitus presented with generalised paraesthesia and spontaneous tetany. She had received denosumab 60 mg subcutaneously 8 weeks previously for parathyroid hormone independent hypercalcaemia.At admission, she had severe hypocalcaemia (5 mg/dL), hypophosphataemia (1.9 mg/dL), hypomagnesaemia (1.4 mg/dL) and elevated serum creatinine (1.48 mg/dL) with prolonged QTc (corrected QT interval) on electrocardiograph. She initially received intravenous calcium and magnesium followed by oral calcium carbonate and calcitriol. Her prednisolone dose was tapered to 5 mg/day. Evaluation showed secondary hyperparathyroidism (1474 pg/mL) and elevated 1,25-dihydroxy vitamin D (195 pg/mL). After 1 week of oral calcium carbonate (3000 mg/day) and calcitriol (1.5 µg/day), she achieved normocalcaemia (8.1 mg/dL).To conclude, denosumab for hypercalcaemia with renal insufficiency causes prolonged severe symptomatic hypocalcaemia and hypophosphataemia mimicking hungry bone syndrome. It is important to periodically monitor for hypocalcaemia after denosumab.


Assuntos
Doenças Ósseas Metabólicas , Glomerulonefrite por IGA , Hipercalcemia , Hiperparatireoidismo Secundário , Hipocalcemia , Hipofosfatemia , Sarcoidose , Doenças Ósseas Metabólicas/tratamento farmacológico , Calcitriol/uso terapêutico , Cálcio/uso terapêutico , Carbonato de Cálcio/uso terapêutico , Denosumab/efeitos adversos , Feminino , Glomerulonefrite por IGA/complicações , Humanos , Hipercalcemia/complicações , Hipercalcemia/etiologia , Hiperparatireoidismo Secundário/complicações , Hipocalcemia/induzido quimicamente , Hipocalcemia/complicações , Hipocalcemia/tratamento farmacológico , Hipofosfatemia/complicações , Hormônio Paratireóideo , Sarcoidose/complicações
6.
Br J Hosp Med (Lond) ; 83(6): 1-7, 2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35787163

RESUMO

Hypercalcaemia is a common metabolic abnormality and its differential diagnosis is vast. Immobility is an uncommon cause of hypercalcaemia. Immobilisation hypercalcaemia is independent of parathyroid hormone and is associated with low levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. In addition, it is characterised by elevated levels of markers of bone resorption and low levels of bone-specific alkaline phosphatase, highlighting an imbalance of bone remodelling favouring osteoclastic bone resorption. Although immobilisation hypercalcaemia is a diagnosis of exclusion, physicians need to be aware of this condition to avoid excessive and invasive investigations when all other causes of parathyroid hormone-independent hypercalcaemia have been excluded. Management of immobilisation hypercalcaemia revolves around early mobilisation and rehabilitation together with pharmacotherapeutic agents such as intravenous isotonic saline, calcitonin and bisphosphonates. Denosumab may be a potential alternative yet off-label treatment for immobility hypercalcaemia in patients with renal insufficiency.


Assuntos
Reabsorção Óssea , Hipercalcemia , Reabsorção Óssea/complicações , Reabsorção Óssea/tratamento farmacológico , Diagnóstico Diferencial , Difosfonatos/uso terapêutico , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Hipercalcemia/terapia , Hormônio Paratireóideo/uso terapêutico
7.
G Ital Nefrol ; 39(3)2022 Jun 20.
Artigo em Italiano | MEDLINE | ID: mdl-35819043

RESUMO

Introduction: persistent hypercalcemic secondary hyperparathyroidism (PSHPT) in kidney transplantation (KTx) can expose renal transplant recipients (RTRs) to a series of complications. Cinacalcet has been shown to be effective in controlling hypercalcemic PSHPT. Therefore, we evaluated the efficacy and tolerability of cinacalcet, over a period of 3 years, in the treatment of hypercalcemic PSHPT in a group of RTRs. Patients and Methods: eight patients with a kidney transplant age > 12 months, parathyroid hormone (PTH) levels > 120 pg/ml and total serum calcium (TCa) levels > 10.5 mg/dl, were treated with cinacalcet at an initial dose of 30 mg/day. Hypercalcemic PSHPT picture must have been present for at least 6 months before the start of treatment with cinacalcet. Every 6-8 weeks were determined: estimated glomerular filtration rate (eGFR), PTH, TCa, serum phosphorus, fractional excretion of calcium (FECa), tubular maximum reabsorption rate of phosphate (TmP/GFR), serum tacrolimus. Annually all patients underwent to ultrasound control of the transplanted kidney. The main endpoints of the study were the reduction of PTH levels > 30% from baseline and the normalization of TCa levels (<10.2 mg/dl). Results: the results are shown as median ± interquartile range (IQR). At follow-up PTH levels decreased from 223 (202-440) to 135 pg/ml (82-156) (P < 0.01), with a percentage decrease of -54 (-68;-44), TCa levels decreased from 11.0 (10.7-11.7) to 9.3 mg/dl (8.8-9.5) (P < 0.001). Serum phosphorus levels increased from 2.7 (2.0-3.0) to 3.2 mg/dl (2.9-3.5) (P < 0.05). Fractional excretion of calcium did not change, while TmPO4/GFR increased even not significantly. Renal function and serum levels of tacrolimus did not change throughout the observation period. At end of the study the average cinacalcet dosages were 30 mg/day (30-30). Ultrasound scans of the transplanted kidney showed no development of nephrocalcinosis and/or nephrolithiasis. Conclusions: cinacalcet has proved effective and well tolerated in the treatment of hypercalcemic PSHPT in RTRs.


Assuntos
Hipercalcemia , Hiperparatireoidismo Secundário , Transplante de Rim , Cálcio , Cinacalcete/uso terapêutico , Humanos , Hipercalcemia/tratamento farmacológico , Hipercalcemia/etiologia , Hiperparatireoidismo Secundário/tratamento farmacológico , Hiperparatireoidismo Secundário/etiologia , Lactente , Transplante de Rim/efeitos adversos , Hormônio Paratireóideo , Fósforo , Tacrolimo/uso terapêutico
8.
Endocrine ; 77(3): 556-560, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35821184

RESUMO

PURPOSE: Primary hyperparathyroidism (PHPT) in pregnancy is rare enough and can be unrecognized because of nonspecific symptoms in most cases, but life-threatening complications for mother, fetus and neonate also occurs. PHPT requires frequent monitoring of the mother and fetus by a multidisciplinary team. Diagnostics and treatment approaches are limited and require individual risk-benefit assessment. METHODS: In this paper we describe 3 cases of PHPT in pregnant women with different managing approaches (surveillance, drug therapy and surgical treatment) and successful outcomes. Additionally, the most actual literature data on this problem is reviewed. RESULTS: The management of PHPT in pregnancy should be based on the clinical features, severity of hypercalcemia, gestational age and patient's preference. In the first case a conservative approach with low-calcium diet and oral hydration resulted in mother's reduced serum calcium level before delivery. The second patient had severe hypercalcemia and absolute indications for surgery that was successfully performed at 25 week of gestation. The third woman received cinacalcet because of severe hypercalcemia and potential perioperative risks in the third trimester with an improvement in well-being. CONCLUSION: Nowadays parathyroidectomy is the best choice for patients with symptomatic PHPT and severe hypercalcemia. This intervention should be carried out preferably in the second trimester to avoid maternal and fetal complications. Mild forms of the disease can require just a conservative management. The drug treatment of PHPT during pregnancy is still controversial.


Assuntos
Hipercalcemia , Hiperparatireoidismo Primário , Complicações na Gravidez , Cálcio , Cinacalcete , Feminino , Humanos , Hipercalcemia/etiologia , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/diagnóstico , Hiperparatireoidismo Primário/terapia , Recém-Nascido , Paratireoidectomia/efeitos adversos , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapia
9.
Thorac Cancer ; 13(16): 2398-2400, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35811296

RESUMO

Cavitary lung lesions found on chest imaging may point to various diseases. These lesions may be caused by numerous etiologies, such as infection, inflammatory diseases, or malignancy. Thus, its etiology may be challenging to differentiate using imaging alone. Differential diagnoses are created using a combination of clinical symptoms, medical history, laboratory results, and physical examination. Primary pulmonary lymphoma and anaplastic large cell lymphoma (ALCL) are rare differentials. Here, we report a case of ALCL that initially presented with back pain, intermittent fever, hemoptysis, hypercalcemia, and bilateral multiple cavitary lung nodules. Because a cavitary pulmonary mass with sustained hypercalcemia is commonly seen in patients with squamous cell carcinomas or pulmonary tuberculosis, patients with ALCL may be misdiagnosed and undergo delayed treatment. This study highlights that ALCL should be considered in patients presenting with a cavitary pulmonary mass and hypercalcemia.


Assuntos
Carcinoma de Células Escamosas , Hipercalcemia , Linfoma Anaplásico de Células Grandes , Nódulos Pulmonares Múltiplos , Carcinoma de Células Escamosas/diagnóstico , Diagnóstico Diferencial , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma Anaplásico de Células Grandes/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/diagnóstico
11.
J Int Med Res ; 50(6): 3000605221106419, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35734999

RESUMO

An uncommon cause of primary hyperparathyroidism is a cystic parathyroid adenoma. This paper describes two patients with hypercalcemia and right knee disease. Their serum calcium concentration was high, phosphorus concentration was low, and parathyroid hormone (PTH) concentration was high. Ultrasound and computed tomography scans of the neck indicated a cystic mass near the thyroid. Parathyroid scintigraphy showed no focal uptake in one patient and low tracer concentration in the cystic mass in the other patient. Following resection of the cystic masses, both were pathologically confirmed to be a cystic parathyroid adenoma with predominantly cystic degeneration. The calcium and PTH concentrations gradually decreased to the reference range. Both patients were stable at their last follow-up. The diagnosis of a functional cystic parathyroid adenoma is highly challenging because of the different clinical manifestations and negative result on parathyroid tracer scintigraphy. For patients with high serum calcium and PTH concentrations and a cystic mass in the neck, resection of the mass and subsequent postoperative pathological diagnosis is necessary even if the clinical diagnosis of a parathyroid adenoma cannot be confirmed preoperatively. Decreases in the PTH and serum calcium concentrations indicate successful resection of a functional parathyroid adenoma.


Assuntos
Hipercalcemia , Neoplasias das Paratireoides , Cálcio , Humanos , Hipercalcemia/etiologia , Pescoço/patologia , Hormônio Paratireóideo , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/diagnóstico por imagem
12.
BMC Nephrol ; 23(1): 212, 2022 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-35710357

RESUMO

BACKGROUND: Hypercalcemic hyperparathyroidism has been associated with poor outcomes after kidney transplantation (KTx). However, the clinical implications of normocalcemic hyperparathyroidism after KTx are unclear. This retrospective cohort study attempted to identify these implications. METHODS: Normocalcemic recipients who underwent KTx between 2000 and 2016 without a history of parathyroidectomy were included in the study. Those who lost their graft within 1 year posttransplant were excluded. Normocalcemia was defined as total serum calcium levels of 8.5-10.5 mg/dL, while hyperparathyroidism was defined as when intact parathyroid hormone levels exceeded 80 pg/mL. The patients were divided into two groups based on the presence of hyperparathyroidism 1 year after KTx. The primary outcome was the risk of graft loss. RESULTS: Among the 892 consecutive patients, 493 did not have hyperparathyroidism (HPT-free group), and 399 had normocalcemic hyperparathyroidism (NC-HPT group). Ninety-five patients lost their grafts. Death-censored graft survival after KTx was significantly lower in the NC-HPT group than in the HPT-free group (96.7% vs. 99.6% after 5 years, respectively, P < 0.001). Cox hazard analysis revealed that normocalcemic hyperparathyroidism was an independent risk factor for graft loss (P = 0.002; hazard ratio, 1.94; 95% confidence interval, 1.27-2.98). CONCLUSIONS: Normocalcemic hyperparathyroidism 1 year after KTx was an independent risk factor for death-censored graft loss. Early intervention of elevated parathyroid hormone levels may lead to better graft outcomes, even without overt hypercalcemia.


Assuntos
Hipercalcemia , Hiperparatireoidismo Primário , Transplante de Rim , Cálcio , Humanos , Hipercalcemia/etiologia , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/cirurgia , Transplante de Rim/efeitos adversos , Hormônio Paratireóideo , Paratireoidectomia/efeitos adversos , Estudos Retrospectivos , Fatores de Risco
13.
N Z Med J ; 135(1556): 124-126, 2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35728255

RESUMO

Calcium sulfate beads (CSBs) are used as a method of delivery of antibiotics in periprosthetic joint infections, non-union and chronic osteomyelitis.[[1-3]] Symptomatic hypercalcaemia can occur as a complication following the insertion of CSBs however it is rare and few cases have been reported.[[4-7]] The cause of hypercalcaemia is poorly understood.


Assuntos
Artrite Infecciosa , Hipercalcemia , Antibacterianos/uso terapêutico , Artrite Infecciosa/tratamento farmacológico , Cálcio , Sulfato de Cálcio/efeitos adversos , Humanos , Hipercalcemia/tratamento farmacológico , Hipercalcemia/etiologia , Nova Zelândia
14.
N Engl J Med ; 386(26): 2540, 2022 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-35767455
16.
Pan Afr Med J ; 41: 257, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35734323

RESUMO

Malignant hypercalcaemia is a metabolic emergency. Its association with solid tumors is common, whereas it has been rarely described in patients with malignant hemopathies other than multiple myeloma and T-cell leukemias/T-cell lymphomas associated with lymphotropic virus type I (HTLV-I). We here report the case of a female patient with acute lymphoblastic leukemia revealed by malignant hypercalcaemia and pathological fracture of the humerus. Laboratory tests showed aregenerative, normocytic-normochromi anemia, hypercalcaemia (163mg/l), renal failure, creatinine (22mg/l), glomerular filtration rate 26 ml/min and low parathyroid hormone (PTH) (9.9pg/ml). X-ray of the right upper limb showed pathological fracture of humerus. Myelogram and immunophenotyping confirmed the diagnosis of LAL-B. The patient received urgent treatment for hypercalcaemia and the underlying malignancy. This study focuses attention on this atypical condition occurring during acute leukemias and on its diagnostic and therapeutic issues.


Assuntos
Fraturas Espontâneas , Hipercalcemia , Linfoma , Leucemia-Linfoma Linfoblástico de Células Precursoras , Feminino , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Síndromes Paraneoplásicas , Hormônio Paratireóideo/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico
17.
Am J Case Rep ; 23: e936204, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35642124

RESUMO

BACKGROUND Severe hypercalcemia is a life-threatening medical emergency. Its possible etiologies are hyperparathyroidism, malignancy, chronic granulomatous diseases, vitamin D intoxication, medication (lithium, thiazine, excessive vitamin A), hyperthyroidism, acromegaly, adrenal insufficiency, pheochromocytoma, milk-alkali syndrome, and immobilization. Dehydration is considered a consequence of hypercalcemia but not the etiology. CASE REPORT We present a case of a 50-year-old woman who presented with headache, nausea, dizziness, and profound weakness, with a serum calcium level of 17.3 mg/dL due to severe dehydration. The other causes of hypercalcemia were diligently excluded with extensive laboratory testing. The patient's calcium level improved with aggressive intravenous hydration. In the subsequent follow-up visits, the calcium level remained within the reference range. The pathophysiology of severe hypercalcemia caused by dehydration is not clear. However, a feedforward mechanism has been proposed to occur, which worsens both dehydration and hypercalcemia. Dehydration as an initial insult leads to mild or transient hypercalcemia due to decreased fluid volume that affects calcium excretion via the kidneys. Subsequently, hypercalcemia interferes with the kidney's ability to concentrate urine, leading to further dehydration. This sets up a vicious loop that worsens both dehydration and hypercalcemia, leading to profound dehydration and severe hypercalcemia. CONCLUSIONS Dehydration is considered a consequence of hypercalcemia but has not been identified as the etiology of severe hypercalcemia. Hyperparathyroidism and malignancy are the most common causes of severe symptomatic hypercalcemia, and dehydration is the diagnosis of exclusion. However, it is imperative to keep dehydration in the differential diagnosis for a patient presenting with severe symptomatic hypercalcemia, as highlighted by our case.


Assuntos
Hipercalcemia , Hiperparatireoidismo , Neoplasias , Cálcio , Desidratação/complicações , Feminino , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Hiperparatireoidismo/complicações , Pessoa de Meia-Idade , Neoplasias/complicações
18.
Nurse Pract ; 47(7): 24-30, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35758916

RESUMO

ABSTRACT: Hypercalcemia is a frequent and often incidental finding in primary care. The most common causes for hypercalcemia are primary hyperparathyroidism and malignancy. Providers should feel confident in progressing through an initial evaluation with appropriate diagnostics, interventions, and suitable and timely specialty referrals.


Assuntos
Hipercalcemia , Hiperparatireoidismo , Neoplasias , Eletrólitos , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Hiperparatireoidismo/complicações , Atenção Primária à Saúde
19.
Ned Tijdschr Geneeskd ; 1662022 06 21.
Artigo em Holandês | MEDLINE | ID: mdl-35736361

RESUMO

BACKGROUND: Hyperkalemia is a common yet dangerous phenomenon in patients with chronic kidney disease (CKD). Patients suffering from CKD are therefore often treated with potassium-binding supplements such as calcium polystyrene sulfonate (CPS). Hypercalcemia is a known side effect of CPS. However, the increase in serum calcium is usually small. CASE DESCRIPTION: A 68 year old male patient suffering from CKD was treated with a daily administration of 80mg CPS. He presented with complaints of a dry mouth, thirst and malaise. Blood tests showed an elevated serum calcium of 3,25 mmol/L (2,15- 2,55 mmol/L). Additional diagnostics revealed no abnormalities. The hypercalcemia was attributed to the use of CPS only after the exclusion of a wide differential diagnosis. CONCLUSION: Although CPS induced hypercalcemia is usually mild, a more severe course is possible. Knowledge about the composition of medication is paramount to prevent such side effects.


Assuntos
Hipercalcemia , Hiperpotassemia , Insuficiência Renal Crônica , Idoso , Cálcio/uso terapêutico , Quelantes/efeitos adversos , Humanos , Hipercalcemia/induzido quimicamente , Hipercalcemia/etiologia , Hiperpotassemia/diagnóstico , Hiperpotassemia/etiologia , Masculino , Potássio/uso terapêutico , Insuficiência Renal Crônica/induzido quimicamente
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