What is the mechanism of hypercalcaemia of malignancy?
The pathophysiology of hypercalcemia of malignancy is mainly through three mechanisms: excessive secretion of parathyroid hormone-related protein (PTHrP), bony metastasis with the release of osteoclast activating factors, and production of 1,25-dihydroxy vitamin D (calcitriol).
Which malignancy is most commonly associated with hypercalcemia?
The most common cancers associated with hypercalcemia in the United States are breast, renal, and lung cancer and multiple myeloma . Malignancy is usually evident clinically by the time it causes hypercalcemia, and patients with hypercalcemia of malignancy often have a poor prognosis.
What are the two most common conditions that cause hypercalcemia?
Hypercalcemia is usually a result of overactive parathyroid glands. These four tiny glands are situated in the neck, near the thyroid gland. Other causes of hypercalcemia include cancer, certain other medical disorders, some medications, and taking too much of calcium and vitamin D supplements.
What malignancy is hypercalcemia?
Hypercalcemia of malignancy is a common finding typically in patients with advanced stage cancers. Hypercalcemia of malignancy usually presents with markedly elevated calcium levels and patients are therefore usually severely symptomatic.
What are common signs and symptoms of hypercalcemia of malignancy?
If you do have symptoms, they may includes:
- Loss of appetite.
- Nausea and vomiting.
- Constipation and abdominal (belly) pain.
- The need to drink more fluids and urinate more.
- Tiredness, weakness, or muscle pain.
- Confusion, disorientation, and difficulty thinking.
What is the first line treatment for hypercalcemia?
Intravenous bisphosphonates are the treatment of first choice for the initial management of hypercalcaemia, followed by continued oral, or repeated intravenous bisphosphonates to prevent relapse.
Which of the following agents is used to treat hypercalcemia of malignancy?
Choice of drug — Among the currently available agents for the treatment of malignancy-associated hypercalcemia (pamidronate, zoledronic acid [ZA], ibandronate, clodronate, and etidronate), we suggest intravenous (IV) ZA.
How long can a person live with hypercalcemia?
Unfortunately, cancer-related hypercalcemia has a poor prognosis, as it is most often associated with disseminated disease. Eighty percent of patients will die within a year, and there is a median survival of 3 to 4 months.
What is a normal PTHrP level?
Mean serum PTHrP levels were 4.9 +/- 0.5 pmol/L (normal, <2.5) and values above the normal range were found in 53% of the patients (76% in lung and upper respiratory tract malignancies).
Should I worry if my calcium is high?
High blood calcium can lead to many serious health problems and should almost always be treated with an operation to remove the parathyroid tumor. Over 99% of all cases of high calcium in the blood are due to a small tumor on one of the parathyroid glands causing a disease called primary hyperparathyroidism.
What are the signs and symptoms of parathyroid disease?
Parathyroid Disease Symptoms
- A lump in the neck.
- Difficulty speaking or swallowing.
- Muscle weakness.
- Sudden increase in blood calcium levels (hypercalcemia)
- Fatigue, drowsiness.
- Urinating more than usual, which may cause you to be dehydrated and very thirsty.
- Bone pain and broken bones.
- Kidney stones.
Can hypercalcemia be cured?
Treatment is aimed at the cause of hypercalcemia whenever possible. People with primary hyperparathyroidism (PHPT) may need surgery to remove the abnormal parathyroid gland. This will cure the hypercalcemia. People with mild hypercalcemia may be able to monitor the condition closely over time without treatment.
What is the antidote for hypercalcemia?
Cinacalcet (Sensipar) has been approved for managing hypercalcemia. Bisphosphonates. Intravenous osteoporosis drugs, which can quickly lower calcium levels, are often used to treat hypercalcemia due to cancer.