Different mechanisms are responsible for hypercalcemia, enclosed: (1) degradation of bone matrix in patients with osteolitic lesions (i.e. lung, renal and head & neck cancer), (2) abnormal conversion of vitamin D3 within lymphoma cells and (3) secre-tion of parathyroid hormone-related protein (PTHrP), which represents the principal pathway leading to hypercalcemia in cancer patients. Most hypercalcemic patients with bone metastases may have also increased levels of PTHrP and the serum PTH measurement represents the first step in the differential diagnosis from benign (i.e. primary hyperparathyroidism) versus malignant hypercalcemia. Unfortunately, signs and symptoms (nausea, weackness, polyuria, lethargy, depression) are aspecific, but low PTH levels together with high calcium levels in a cancer patient may suggest a malignancy-related hypercalcemic syndrome.
Malignancy-related Hypercalcemia: Pathophysiology and Treatment
LUMACHI, FRANCO;
2008
Abstract
Different mechanisms are responsible for hypercalcemia, enclosed: (1) degradation of bone matrix in patients with osteolitic lesions (i.e. lung, renal and head & neck cancer), (2) abnormal conversion of vitamin D3 within lymphoma cells and (3) secre-tion of parathyroid hormone-related protein (PTHrP), which represents the principal pathway leading to hypercalcemia in cancer patients. Most hypercalcemic patients with bone metastases may have also increased levels of PTHrP and the serum PTH measurement represents the first step in the differential diagnosis from benign (i.e. primary hyperparathyroidism) versus malignant hypercalcemia. Unfortunately, signs and symptoms (nausea, weackness, polyuria, lethargy, depression) are aspecific, but low PTH levels together with high calcium levels in a cancer patient may suggest a malignancy-related hypercalcemic syndrome.Pubblicazioni consigliate
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