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Hypercalcemia

 
  By : , NJ, USA       17.8.2010         Phone:-          Fax:-          Mail Now
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Normal calcium level is 9-11 mq/L. When calcium levels in the blood are above 11, it is called Hypercalcemia. Calcium is required for a number of functions in the body such as bone formation, muscle contraction, nerve conduction, clotting of blood, and the release of hormones. 



Calcium is mainly stored in bones. Body calcium is regulated by parathyroid hormone and calcitonin. When calcium levels are low, parathyroid hormone levels is increased. Parathyroid hormone increases the release of calcium from bones and increases the absorption of calcium from the intestines. It also decreases the calcium excretion by the kidneys. Calcitonin is another hormone, produced by the thyroid gland. When calcium levels are elevated, calcitonin levels is released and by negative feedback, calcium levels are lowered by preventing further release of calcium from bones. In Hypercalcemia, this control is thrown off balance. 

Causes

1. overactive parathyroid gland
2. cancer- breast, lung, and bone metastasis
3. other diseases which cause tissue injury such as TB and sarcoidosis
4. medications such as lithium and thiazide diuretics
5. dehydration

Symptoms

1. Loss of appetite
2. excessive thirst 
3. frequent urination
4. nausea, and vomiting
5. constipation
6. abdominal pains
7. muscle weakness
8. joint pains
9. confusion and lethargy

Diagnosis

1. history
2. physical examination
3. calcium levels
4. parathyroid levels
5. chest x-ray, ct scan, MRI- to detect any possible malignancy or granulomatous diseases such as TB or sarcoid

Treatment

Severe Hypercalcemia needs to be treated in the hospital. 
1. IV fluids are used, as are diuretics to keep the kidneys functioning and to flush the excessive calcium out. 
2. IV bisphosphonates are used to decrease bone loss. 
3. Calcitonin is used to decrease bone reabsorption. 
4. Corticosteroids are used to decrease the effect of vitamin D intoxication. 
5. Hemodialysis

Once calcium levels are decreased below dangerous levels, the cause has to be identified and treated. 

A diagnosis such as primary Hyperparathyroidism, if not medically controlled, needs to be treated with surgery. 

Complication

1. Osteoporosis- bone releases calcium into the blood and becomes weak. This can lead to fractures and loss of height.
2. Kidney stones- crystals are formed in kidneys which can lead to stone formation.
3. Kidney failure
4. Nervous system dysfunction- confusion, dementia, coma which can be fatal
5. Cardiac irregularities



TAGS: Hypercalcemia,   high calcium levels in the blood,  




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