Unusual cause of hypercalcaemia in end stage renal failure patients
We present two cases of our dialysis patients, who were clinically unwell from hypercalcemia. We were initially uncertain of the cause of hypercalcemia as despite our attempts to adjust treatment based on their biochemical findings, we were unable to correct the hypercalcemia. We did not have appropriate bone turnover markers to guide us and out of desperation, anti‐resorptives—calcitonin and bisphosphonate were given with good clinical response. We concluded that the hypercalcemia was related to immobility‐induced hypercalcemia and the inappropriately low iPTH was a red herring. Immobility‐induced hypercalcaemia should be considered in patients with end stage renal failure on renal replacement therapy, especially in those with recent and significant immobility. In these patients, pamidronate can be considered should the hypercalcaemia persist.
Publication date: Available online 30 September 2020Source: Journal of Hazardous MaterialsAuthor(s): Anthony Beauvois, Delphine Vantelon, Jacques Jestin, Martine Bouhnik-Le Coz, Charlotte Catrouillet, Valérie Briois, Thomas Bizien, Mélanie Davranche
Publication date: Available online 10 October 2020Source: American Journal of Kidney DiseasesAuthor(s): Ibironke W. Apata, Sarah Kabbani, Alicia M. Neu, Tamara M. Kear, Erika M.C. D’Agata, David J. Levenson, Alan S. Kliger, Lauri A. Hicks, Priti R. Patel, authors constitute the ASN and CDC Antibiotic Stewardship White Paper Writing Group
Authors: Hernández Pardines F, Serra Verdú MC, Bernal Vidal A, Mayol Belda JM, Mengual Verdú E Abstract The case concerns a 58 year-old female with no medical history of interest who consulted due to binocular diplopia of one week onset. It was associated with costal pain, dyspnoea, intense asthenia and weight loss of 2 months onset. In the blood analysis in the Emergency Department it showed hypercalcaemia, renal failure, and bicytopenia. The chest x-ray showed lytic bone lesions that initially lead to multiple myeloma with extra-osseous involvement. In addition to the corresponding study, in ...
Plasma cell disorders result from a clonal proliferation of bone marrow plasma cells and range from relatively benign monoclonal gammopathy of undetermined significance (MGUS) to malignant myeloma. Serum or urine monoclonal protein is usually detectable. MGUS is asymptomatic but can progress to myeloma or lymphoma. Myeloma is generally a disease of elderly individuals and presents with variable problems including anaemia, bone pain, fractures, spinal cord compression, renal failure, hypercalcaemia, recurrent infections and hyperviscosity.
es JC Abstract Multiple myeloma (MM) is a haematologic malignancy characterized by the expansion of monoclonal plasma cells in the bone marrow. It is associated with serum or urine monoclonal protein and organ damage including renal failure, anaemia, hypercalcaemia and bone lesions. Despite recent improvements MM still remains an incurable disease. Previous studies have shown that the adoptive transfer of autologous T-cells modified to express chimeric antigen receptors (CAR) is effective in cases of acute and chronic lymphoid leukaemia. However, the adjustment of CAR-T-cell therapy to MM is hindered by the scarci...
Abstract Primary hyperparathyroidism (pHPT) is a common endocrine disease characterized by excessive secretion of parathyroid hormone and an increased level of serum calcium. Overall, 80–85% of pHPT cases are due to a benign, single parathyroid adenoma (PA), and 15% to multiglandular disease (multiple adenomas/hyperplasia). Parathyroid carcinoma (PC) is rare, accounting for
CONCLUSIONS: Cinacalcet at low doses is effective in the management of SHPT in CKD patients who are not on dialysis. Its use reduces iPTH and calcaemia, without causing serious side effects or significant changes in renal function. PMID: 26906451 [PubMed - as supplied by publisher]
We report a patient presenting with a triad of hypercalcemia, metabolic alkalosis, and renal failure secondary to treatment of iatrogenic hypoparathyroidism and osteoporosis. Persistent ingestion of calcium carbonate and vitamin D caused milk-alkali syndrome. The patient was managed with intravenous fluids and withdrawal of calcium carbonate and vitamin D. She responded well to the treatment and the calcium concentration, renal function and metabolic alkalosis were normalized. Milk-alkali syndrome may be important as a reemerging cause of hypercalcemia. PMID: 21468203 [PubMed]
Multiple myeloma (MM) is an incurable haematological malignancy in which clonal plasma cells proliferate and expand within the bone marrow, leading to osteolytic bone destruction, hypercalcaemia, renal failure, and anaemia. In the past decade, survival has improved due to the introduction of novel therapeutic agents, particularly proteasome inhibitors and immunomodulatory drugs (IMIDs) .
We report a 57‐year‐old male, who presented with anaemia, hypercalcaemia, acute renal failure and several vertebral fractures that clinically suggested a multiple myeloma. Further investigations revealed a serum monoclonal component of IgM lambda type and a bone marrow infiltrated by small, lymphoplasmocytic cells. IgM MM was finally diagnosed by means of both inmunophenotypic and immunohistochemistry techniques, stressing the importance of inmunophenotypic evaluation when clinical and morphological features are discordant. Fluorescence in situ hybridization (FISH) studies disclosed a particular combination of del...