Severe Life-threatening Hypercalcemia in Skeletal Metastasis from Malignancy of Unknown Origin: A Rare Presentation

JOURNAL TITLE: AMEI's Current Trends in Diagnosis & Treatment

Author
1. Srishti Nayyar
ISSN
2582-4260
DOI
10.5005/jp-journals-10055-0094
Volume
4
Issue
1
Publishing Year
2020
Pages
2
Author Affiliations
    1. Department of Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
  • Article keywords

    Abstract

    Severe hypercalcemia is a life-threatening condition. Hypercalcemia of malignancy can occur as a result of 4 different mechanisms, the most common mechanism being humoral hypercalcemia of malignancy (HHM). The second most common mechanism that majorly concerns our case is osteolytic hypercalcemia. In patients with osseous metastases, increased cytokine activity in the region of lytic osseous metastatic lesions greatly stimulate the activity of osteoclasts in the bone. When compensatory mechanisms are exceeded, the serum calcium level rises causing hypercalcemia. Symptoms and signs include nausea and vomiting, fatigue, depression, confusion, psychosis, abdominal pain, constipation, acute pancreatitis, peptic ulceration, polyuria/nocturia, hematuria, renal colic, renal failure, bone pain, hypertension, and arrhythmias. We present this case of severe hypercalcemia to emphasize the severity of disease associated with lytic skeletal metastasis with an emphasis on early management, diagnosis, and interventions to prevent early mortality.

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