Hypercalcemia Pathophysiology & Treatment


by

Franco Lumachi

DOI: 10.2174/97816080510761100101
eISBN: 978-1-60805-107-6, 2010
ISBN: 978-1-60805-358-2

  
  


Indexed in: Scopus

Hypercalcemia is a relatively common disorder, which requires specific treatment in order to control symptoms and prevent the developm...[view complete introduction]
PDF US $
- Single user / Non-Library usage: 22
- Multi user / Library usage: 88
Print-On-Demand (P.O.D): *53
Special Offer for Single user / Non-Library usage (PDF + P.O.D): *64

*(Excluding Mailing and Handling)
Purchase: Book Chapters
Download Flyers

Table of Contents

Foreword , Pp. i

Franco Lumachi and Stefano M.M. Basso
Download Free

Preface , Pp. ii

John G. Delinassios
Download Free

Contributors , Pp. iii-iv (2)

Franco Lumachi and Stefano M.M. Basso
Download Free

Acronyms used in this book , Pp. v-vi (2)

Franco Lumachi and Stefano M.M. Basso
Purchase Chapter

Renal Diseases & Hypercalcemia , Pp. 1-17 (17)

Walter Mancini, Franco Lumachi and Stefano M.M. Basso
Purchase Chapter

Primary Hyperparathyroidism & Benign Diseases , Pp. 18-27 (10)

Franco Lumachi and Stefano M.M. Basso
Purchase Chapter

Hypercalcemia and Malignancy , Pp. 28-37 (10)

Umberto Basso, Anna Roma and Antonella Brunello
Purchase Chapter

Acute Hypercalcemia , Pp. 38-44 (7)

Fabiana Nascimben
Purchase Chapter

Laboratory & Hypercalcemia , Pp. 45-61 (17)

Piero Cappelletti and Renato Tozzoli
Purchase Chapter

Imaging Studies in Patients with Hypercalcemia , Pp. 62-75 (14)

Grazia Guzzetta, Maria Guzzetta and Gianpietro Feltrin
Purchase Chapter

Surgical Treatment of Hypercalcemia , Pp. 76-87 (12)

Stefano M.M. Basso and Franco Lumachi
Purchase Chapter

Medical Treatment of Hypercalcemia , Pp. 88-99 (12)

Valentina Camozzi, Chiara Franzin and Giovanni Luisetto
Purchase Chapter

Index , Pp. 100-105 (6)

Franco Lumachi and Stefano M.M. Basso
Download Free

Foreword

Hypercalcemia is a relatively common disorder, which requires specific treatment in order to control symptoms and prevent the development of organ damage. Since primary hyperparathyroidism and malignancy are responsible for more than 90% of all cases of hypercalcemia, greater interest was given in terms of developing the best strategy to manage these two critical situations.

The aim of this book is to present up-to-date knowledge on hypercalcemia, its association with renal disorders, and benign and malignant diseases, diagnostic methodologies, as well as surgical and medical treatment. Insights into the etiology, pathogenesis and pathophysiology of hypercalcemia are included in the first four chapters, also providing comprehensive descriptions of clinical features, diagnostic and treatment procedures in the specific diseases associated with hypercalcemia.

The other chapters present details on biochemical findings and ways to monitor complications and therapy, giving suggestions on the current imaging techniques, and deal with the criteria, procedures and results of surgical treatment of hypercalcemia, including unilateral and minimally-invasive parathyroidectomy. Finally, a specific chapter describes the pharmacology of anti-hypercalcemic drugs, also providing information on new drugs and future perspectives.

Uniquely, this book will serve as a complete reference source for oncologists, nephrologists, endocrinologists and other clinicians, as well as for biochemists and pharmacologists, and all those involved in hypercalcemia management and research.

John G. Delinassios
Director
International Institute of Anticancer Research
Athens, Greece


Preface

Changes in serum calcium concentration regulate several fundamental cellular events, including enzy-matic activities, and cell membranes excitability. In adults 99% of calcium is found in the skeleton, in which it plays both structural and regulatory roles. High blood calcium levels (hypercalcemia) is extremely rare under physiological conditions. It usually occurs when parathyroid hormone (PTH) and 1,25 (OH)2 vitamin D act on osteocytic osteolysis and osteoclastic resorption, transferring calcium to the extracellular compartment. Basic mechanisms regulating calcium metabolism have long been defined, but the complete role of new factors, such as fibroblast growth factor-23 (FGF-23), transient receptor potential cation channel, subfamily V member 5 (TRPV5), and the Klotho gene, is still under study. The main causes of hypercalcemia are primary hyperparathyroidism (HPT), and malignancy-associated hypercalcemia (MAH). Severe or prolonged hypercalcemia may cause several complications, mainly depending on serum calcium concentrations. In any case, the clinical features are usually aspecific, such as muscle weakness, fatigability, asthenia, as well as signs and symptoms of dehydration. Other less common causes of hypercalcemia include increased intake of calcium and vitamin D, granulomatous diseases, other endocrine disorders, multiple endocrine neoplasia, familial benign hypocalciuric hypocalcemia, and other rare disorders.

The therapy of choice for HPT is the surgical ablation of the hyperfunctioning parathyroid tissue, and the best time to cure a patient is during the initial phase. In patients with primary HPT, parathyroidectomy produces a sudden modification of the endocrine balance which regulates the calcium and phosphate metabolism. Currently, minimally invasive parathyroidectomy is widely performed, both videoassisted and radioguided. Physiologically, PTH acts directly on the renal and bone cells, and indirectly it influences the intestinal absorption of calcium, stimulating the renal synthesis of [1,25(OH)2]D3. Although there is an immediate renal response to serum PTH levels, The modifications which take place in the bone are slower, according to the particular way of the bone-remodeling process. The antireabsorptive action of bisphopshonates has been considered the most effective in the disorders characterized by an excessive bone resorption. Unfortunately, patients with MAH have usually advanced tumors which explains short survival rate. However, when the first diag-nosis is a chemosensitive tumor, such as multiple myeloma or metastatic breast cancer, long-term remissions may be obtained. Calicimimetic drugs and humanized monoclonal antibody against human parathyroid hormone-related protein represent the new drugs useful to treat hypercalcemia.

Serum calcium has a pivotal role in the homeostasis of an organism, and its alteration has important effects. Knowledge of role and regulatory mechanisms of serum calcium is crucial to understand and diagnose the underlying diseases, that cause hypercalcemia. This book is a compilation of the efforts of a selected group of well-established experts in the field of calcium metabolism, and management of the causes of hypercalcemia. It summarizes the principle findings and points out possible pitfalls in hypercalcemic diseases, with the aim to help both students in the understanding and clinicians in their approach to patients with hypercalcemia.

We would like to thank Director Mahmood Alam and particularly Assistant Manager Asma Ahmed, together with the whole Bentham Science Publishers, for their effort and support.

Franco Lumachi, M.D.
Associate Professor of Surgery
University of Padua, School of Medicine
35128 Padova, Italy

Stefano M.M. Basso, M.D., Ph.D.
Assistant Professor
S. Maria degli Angeli Hospital
33170 Pordenone, Italy

List of Contributors

Editor(s):
Franco Lumachi
University of Padua
Italy




Co-Editor(s):
Stefano M.M. Basso
S.M. degli Angeli Hospital
Italy




Contributor(s):
Stefano M.M. Basso
Assistant Professor, Division of Surgery I, S.M. degli Angeli Hospital
Pordenone, 33170
Italy


Umberto Basso
Assistant Professor, Istituto Oncologico Veneto (IOV), IRCCS
Padova, 35128
Italy


Antonella Brunello
Clinical Research Assistant, Istituto Oncologico Veneto (IOV), IRCCS
Padova, 35128
Italy


Valentina Camozzi
Clinical Research, Department of Medical & Surgical Sciences
University of Padua, School of Medicine
Padova, 35128
Italy


Piero Cappelletti
Director, Department of Clinical Pathology
S. Maria degli Angeli Hospital
Pordenone, 33170
Italy


Gianpietro Feltrin
Professor, Director, Radiology Section, Department of Diagnostic Medical Sciences
University of Padua, School of Medicine
Padova, 35128
Italy


Chiara Franzin
Department of Medical & Surgical Sciences
University of Padua, School of Medicine
Padova, 35128
Italy


Grazia Guzzetta
Radiology Resident, Department of Diagnostic Medical Sciences
University of Padua, School of Medicine
Padova, 35128
Italy


Maria Guzzetta
Radiology Resident, Department of Diagnostic Medical Sciences
University of Padua, School of Medicine
Padova, 35128
Italy


Giovanni , Luisetto
Associate Professor of Internal Medicine, Department of Medical & Surgical Sciences
University of Padua, School of Medicine
Padova, 35128
Italy


Franco Lumachi
Associate Professor of Surgery, Department of Surgical & Gastroenterological Sciences
University of Padua, School of Medicine
Padova, 35128
Italy


Walter Mancini
Assistant Professor, Director, Division of Nephrology
S. Maria degli Angeli Hospital
Pordenone, 33170
Italy


Fabiana Nascimben
Clinical Research, Emergency Department
S. Maria degli Angeli Hospital
Pordenone, 33170
Italy


Anna Roma
Medical Oncology Resident
Istituto Oncologico Veneto (IOV), IRCCS
Padova, 35128
Italy


Renato Tozzoli
Assistant Professor, Director, Department of Clinical Chemistry & Microbiology
City Hospital
Latisana, 33053
Italy




Advertisement


Webmaster Contact: urooj@benthamscience.org Copyright © 2014 Bentham Science