Hypercalcemia: Difference between revisions
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== Associated Co-morbidities == | == Associated Co-morbidities == | ||
Hypercalcemia can lead to many other complications such as:<br> | |||
*'''Osteoporosis''': if the bones continue to release calcium into the blood, it could lead to this disease. | |||
*'''Kidney stones''': this could be caused by too much calcium accumulation in the urine, leading to crystal formation in the kidneys. | |||
*'''Kidney failure''': Severe hypercalcemia can lead to damage in the kidneys and possibly cause permanent loss of kidney function. | |||
*'''Nervous system deficits''': Severe hypercalcemia can lead to dementia and confusion. | |||
*'''Arrythmias''': Hypercalcemia can affect the electrical impulses of cardiac muscle, causing irregular heartbeats. | |||
*'''Primary Hyperparathyroidism''': This is often associated with hypercalcemia because it causes an increased release of parathyroid hormone (PTH) which raises serum calcium levels. | |||
== Medications == | == Medications == |
Revision as of 16:44, 7 April 2013
Original Editors - Whitney Browning & Natalie Elliott from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description
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Hypercalcemia is characterized by elevated calcium levels in the blood. It may include symptoms associated with the musculoskeletal, neurological, cardiovascular, and gastrointestinal systems. Hypercalcemia is often a sign or symptom of other disease occurring within the body. Normal calcium levels range from 8.2-10.2 mg/dL. Mild hypercalcemia occurs when this level drops to 12mg/dL and severe hypercalcemia is classified as serum calcium at 14mg/dL.
Prevalence[edit | edit source]
Hypercalcemia is a rather common medical emergency. Between 20-40% of patients suffering from cancer develp this during the course of their disease. It is considered the most common serious electrolyte presenting in adults with malignancies. This disorder often occurs in cases of metastatic bone disease with osteolytic lesion, breast cancer and myeloma. This is related to an increase in bone resorption caused by tumor cell production of parathyroid hormone-related protein that stimulates osteoclasts. It is also associated with primary hyperparathyroidism which occurs in 25 per 100,000 individuals and 75 per 100,000 hospitalized patients. This condition is the most common cause of mild hypercalcemia and can be treated through outpatient care. More than 50,000 cases occur in the U.S. each year.
Characteristics/Clinical Presentation
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System | Signs/symptoms |
Musculoskeletal |
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Central Nervous System |
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Gastrointenstinal
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Cardiovascular |
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Associated Co-morbidities[edit | edit source]
Hypercalcemia can lead to many other complications such as:
- Osteoporosis: if the bones continue to release calcium into the blood, it could lead to this disease.
- Kidney stones: this could be caused by too much calcium accumulation in the urine, leading to crystal formation in the kidneys.
- Kidney failure: Severe hypercalcemia can lead to damage in the kidneys and possibly cause permanent loss of kidney function.
- Nervous system deficits: Severe hypercalcemia can lead to dementia and confusion.
- Arrythmias: Hypercalcemia can affect the electrical impulses of cardiac muscle, causing irregular heartbeats.
- Primary Hyperparathyroidism: This is often associated with hypercalcemia because it causes an increased release of parathyroid hormone (PTH) which raises serum calcium levels.
Medications[edit | edit source]
Medication | Treatment Effect | Side Effects |
Loop Diuretics (ex; furosemide) | Flushes out excess calcium from system | Frequent urination, arrythmias, electrolyte imbalances, dizziness, muscle cramps/weakness, extreme fatigue, blurred vision, confusion, headache, dehydration, fever, sore throat, cough, skin rash, loss of appetite, nausea, vomiting |
Intravenous Biphosphonates | Prevent bone breakdown, reduce bone pain, reduce the number of pathologic fractures | Heartburn, headache, constipation, diarrhea, muscle and joint pain |
Calcitonin | Reduce bone reabsorption and slow bone loss | Warmth/redness of the skin, itching of the skin, nausea, loss of appetite, stomach pain, vomiting, skin rash, increased urination, eye pain, swelling in the feet, swelling or irritation at injection site (if injection was given) |
Glucocorticoids | Help to counter the effect of excess Vitamin D | Elevated pressure in the eyes, fluid retention that may cause swelling in the legs, increased blood pressure, mood swings, weight gain |
Hemodialysis | Remove excess waste and calcium from the bloodstream | Hypotension, muscle cramps, itching, difficulty sleeping, anemia, pericarditis, hyperkalemia, infection, depression |
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
Common causes of hypercalcemia include: (mayoclinic)
- Overactivity of parathyroid glands
- Cancer-specifically lung and breast cancer as well as multiple myeloma can increase the risk of hypercalcemia. This is considered to be due to the fact that some malignant tumors can produce a protein that acts simlar to the parathyroid hormone which stimulates the release of calcium from the bones into the bloodstream.
- Other disease effects-some people with cancer that causes them to spend increased time laying down or in bed may cause bones to release calcium into the blood due to the lack of weightbearing.
- Medications-Lithium, a drug used to treat bipolar disorder, may increase the release of parathyroid hormone and cause hypercalcemia. Also, Thiazie diuretics can cause elevated calcium levels by decreasing the amount of calcium excreted in the urine.
- Supplements-eating or drinking too much calcium or Vitamin D
- Dehydration-less fluid in your blood causes the calcium levels to increase
Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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