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.
Source: Hemodialysis International - Category: Hematology Authors: Tags: Case Report Source Type: research

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The rapid rise in circulating fibroblast growth factor 23 (FGF23) associated with kidney injury results in calcitriol deficiency, altered calcium homeostasis, and secondary hyperparathyroidism, and may contribute to cardiovascular complications and death. However, the mechanisms of increased FGF23 in states of kidney injury remain unclear. In this issue of the JCI, Simic et al. screened plasma taken from the renal vein of patients undergoing cardiac catheterization and identified glycerol-3-phosphate (G-3-P) as the most significant correlate of simultaneous arterial FGF23 levels. When G-3-P was administered to mice, FGF23 ...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
ConclusionAll 13 pediatric CU families harbored SLC3A1 or/and SLC7A9 rare variants. A total of 15 novel pathogenic variants in SLC3A1 and SLC7A9 were identified. This study expanded the known mutational spectrum of CU in the Chinese population.
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
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 ...
Source: Archivos de la Sociedad Espanola de Oftalmologia - Category: Opthalmology Tags: Arch Soc Esp Oftalmol Source Type: research
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.
Source: Medicine - Category: Internal Medicine Authors: Tags: Lymphoproliferative disorders Source Type: research
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...
Source: Biochemical Society Transactions - Category: Biochemistry Authors: Tags: Biochem Soc Trans Source Type: research
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
Source: Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Review Source Type: research
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]
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
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]
Source: Electrolyte and Blood Pressure - Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research
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Source: Leukemia Research - Category: Hematology Authors: Source Type: research
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...
Source: Clinical and Laboratory Haematology - Category: Hematology Authors: Tags: Case Report Source Type: research
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