Hypercalcaemia of Malignancy

Question 1

what is Hypercalcaemia of malignancy

Answer 1

can occur in cancer patients when their serum calcium rises

Question 2

aetiology of Hypercalcaemia in malignancy

Answer 2

tumours release parathyroid hormone related peptide (PTHrH)

PTHrH activates osteoclasts which break down bone, subsequently releasing calcium

Question 3

risk factors

Answer 3

non-metastatic malignancy

lymphoma

Question 4

presenting symptoms and signs of Hypercalcaemia

Answer 4

nausea, vomitting, confusion, fatigue, constipation, muscle aches, cramps, spasms and twitches, nausea, osmotic symptoms (polyuria, polydipsia), bone pain, joint pain

Question 5

investigations for Hypercalcaemia

Answer 5

serum calcium, serum albumin, serum PTH, PTHrP, ECG, 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D

Question 6

treating Hypercalcaemia

Answer 6

treat the underlying malignancy (eradication of the tumour)

IV saline with bisphosphonates/ OR calcitonin/ OR furosemide

patients may need renal dialysis if the Hypercalcaemia has caused renal damage/ early signs of renal failure

Question 7

prognosis

Answer 7

Intravenous hydration and pharmacological therapy for malignancy-associated hypercalcaemia can provide transient restoration of normocalcaemia. Eradication of underlying malignancy is crucial for permanent reversal of hypercalcaemia.

Question 8

a bit about Calcitriol mediated Hypercalcaemia

Answer 8

needs to be treated with IV hydration and calcitonin AS WELL AS corticosteroids