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Hypercalcemia may be the first sign of multiple myeloma, but not only that


Authors: Z. Adam 1;  K. Starý 2;  K. Zajíčková 3;  Z. Řehák 4;  R. Koukalová 4;  A. Šprláková-Puková 5;  M. Tomíška 1;  M. Doubková 6;  Z. Čermáková 7;  M. Krejčí 1;  V. Sandecká 1;  M. Štork 1;  L. Ostřížková 1;  A. Čermák 8;  L. Pour 1
Authors‘ workplace: Interní hematologická a onkologická klinika LF MU a FN Brno 1;  Interní gastroenterologická klinika LF MU a FN Brno 2;  Endokrinologický ústav, Praha 3;  Oddělení nukleární medicíny, centrum PET, RECAMO. Masarykův onkologický ústav, Brno 4;  Klinika radiologie a nukleární medicíny FN Brno a LF MU v Brně 5;  Klinika nemocí plicních a tuberkulózy LF MU a FN Brno 6;  Oddělení klinické biochemie FN Brno a Katedra laboratorních metod LF MU Brno 7;  Urologická klinika LF MU a FN Brno 8
Published in: Transfuze Hematol. dnes,24, 2018, No. 4, p. 238-252.
Category: Review/Educational Papers

Overview

Hypercalcemia associated with malignancy is relatively common, occurring in up to 20–30% of cancer patients. It can occur in patients with both solid tumours and haematological malignancies, the most common being multiple myeloma, breast cancer, lung cancer and renal cell carcinoma. However, hyperparathyroidism, sarcoidosis and hereditary or acquired endocrine disorders should be considered in the differential diagnosis. The signs and symptoms of hypercalcemia are often nonspecific and include fatigue, nausea, vomiting, constipation and confusion, making the diagnosis challenging. These clinical features often mimic general symptoms of the underlying cancer itself or the adverse effects of treatment such as chemotherapy. The development of hypercalcemia of malignancy indicates a poor prognosis for patients with multiple myeloma or other cancer. This text describes the differential diagnosis and therapy.

Keywords:

hypercalcemia – bisphosphonates – denosumab – multiple myeloma – hyperparathyroidism – sarcoidosis – hereditary hypercalcemia


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