Severe hypercalcaemia from ectopic intact parathyroid hormone secretion treated with continuous renal replacement therapy in a patient with two malignancies
We present a 61-year-old Caucasian woman with endometroid carcinoma as well as a poorly differentiated adenocarcinoma who developed severe hypercalcaemia in the setting of an elevated intact parathyroid hormone. The patient was hospitalised twice for her condition. During her first hospitalisation,...
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| Veröffentlicht in: | BMJ case reports 2021-06, Vol.14 (6), p.e242172 |
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| creator | Hocker, Nathaniel Story, Maria Lerud, Alysa Kuppachi, Sarat |
| description | We present a 61-year-old Caucasian woman with endometroid carcinoma as well as a poorly differentiated adenocarcinoma who developed severe hypercalcaemia in the setting of an elevated intact parathyroid hormone. The patient was hospitalised twice for her condition. During her first hospitalisation, she was diagnosed with an endometroid carcinoma and hypercalcaemia. With medical management, she had a normal calcium level on discharge. She presented 3 weeks later with hypercalcaemia and encephalopathy. This time her hypercalcaemia was refractory to medical management, and required continuous renal replacement therapy (CRRT) to normalise her serum calcium. Lung biopsy revealed a poorly differentiated adenocarcinoma, suspicious for pancreatic primary. Due to her poor prognosis, rapid elevation of calcium with each attempt to discontinue CRRT, and the poor options for treatment of her cancers, she elected to pursue hospice care. |
| doi_str_mv | 10.1136/bcr-2021-242172 |
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The patient was hospitalised twice for her condition. During her first hospitalisation, she was diagnosed with an endometroid carcinoma and hypercalcaemia. With medical management, she had a normal calcium level on discharge. She presented 3 weeks later with hypercalcaemia and encephalopathy. This time her hypercalcaemia was refractory to medical management, and required continuous renal replacement therapy (CRRT) to normalise her serum calcium. Lung biopsy revealed a poorly differentiated adenocarcinoma, suspicious for pancreatic primary. Due to her poor prognosis, rapid elevation of calcium with each attempt to discontinue CRRT, and the poor options for treatment of her cancers, she elected to pursue hospice care.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2021-242172</identifier><identifier>PMID: 34187797</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abdomen ; Biopsy ; Calcium ; Carcinoma ; Cardiac arrhythmia ; Case Report ; Case reports ; Continuous Renal Replacement Therapy ; Creatinine ; Female ; Hemodialysis ; Humans ; Hypercalcemia ; Hypercalcemia - etiology ; Hypercalcemia - therapy ; Hyperplasia ; Hypotension ; Laboratories ; Liver cancer ; Metastasis ; Middle Aged ; Neuroendocrine tumors ; Ovaries ; Pancreas ; Pancreatic cancer ; Parathyroid Hormone ; Renal replacement therapy ; Thyroid gland ; Tumors ; Vagina ; Vitamin D</subject><ispartof>BMJ case reports, 2021-06, Vol.14 (6), p.e242172</ispartof><rights>BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2021 BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ. 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b415t-f3b8da878a894994782c233bb68f680b7dd17e6a0950d692992819650c570f683</citedby><cites>FETCH-LOGICAL-b415t-f3b8da878a894994782c233bb68f680b7dd17e6a0950d692992819650c570f683</cites><orcidid>0000-0001-9360-4089</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245462/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245462/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,725,778,782,883,27911,27912,53778,53780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34187797$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hocker, Nathaniel</creatorcontrib><creatorcontrib>Story, Maria</creatorcontrib><creatorcontrib>Lerud, Alysa</creatorcontrib><creatorcontrib>Kuppachi, Sarat</creatorcontrib><title>Severe hypercalcaemia from ectopic intact parathyroid hormone secretion treated with continuous renal replacement therapy in a patient with two malignancies</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>We present a 61-year-old Caucasian woman with endometroid carcinoma as well as a poorly differentiated adenocarcinoma who developed severe hypercalcaemia in the setting of an elevated intact parathyroid hormone. The patient was hospitalised twice for her condition. During her first hospitalisation, she was diagnosed with an endometroid carcinoma and hypercalcaemia. With medical management, she had a normal calcium level on discharge. She presented 3 weeks later with hypercalcaemia and encephalopathy. This time her hypercalcaemia was refractory to medical management, and required continuous renal replacement therapy (CRRT) to normalise her serum calcium. Lung biopsy revealed a poorly differentiated adenocarcinoma, suspicious for pancreatic primary. Due to her poor prognosis, rapid elevation of calcium with each attempt to discontinue CRRT, and the poor options for treatment of her cancers, she elected to pursue hospice care.</description><subject>Abdomen</subject><subject>Biopsy</subject><subject>Calcium</subject><subject>Carcinoma</subject><subject>Cardiac arrhythmia</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Continuous Renal Replacement Therapy</subject><subject>Creatinine</subject><subject>Female</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Hypercalcemia</subject><subject>Hypercalcemia - etiology</subject><subject>Hypercalcemia - therapy</subject><subject>Hyperplasia</subject><subject>Hypotension</subject><subject>Laboratories</subject><subject>Liver cancer</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neuroendocrine tumors</subject><subject>Ovaries</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Parathyroid Hormone</subject><subject>Renal replacement therapy</subject><subject>Thyroid gland</subject><subject>Tumors</subject><subject>Vagina</subject><subject>Vitamin D</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkU2L1TAUhosoznCdtTsJuBGhTvPRJtkIMowfMOBCBXfhND2d5tImNU1nuP_FH2uuHYfRjVkkh-Q5LyfvWxTPafWGUt6ctzaWrGK0ZIJRyR4Vp1TWspS6-v74QX1SnC3LvsqLU6EEf1qccEGVlFqeFj-_4A1GJMNhxmhhtICTA9LHMBG0KczOEucT2ERmiJCGQwyuI0OIU_BIFrQRkwuepIiQsCO3Lg3EBp-cX8O6kIgexrzPI1ic0CeSBowwH7IsgSya3PHyd1u6DWSC0V178Nbh8qx40sO44NnduSu-vb_8evGxvPr84dPFu6uyFbROZc9b1YGSCpQWWgupmGWct22j-kZVrew6KrGBStdV12imNVNUN3Vla1llgu-Kt5vuvLYTdjYPFGE0c3QTxIMJ4MzfL94N5jrcGMVELRqWBV7dCcTwY8UlmcktFscRPGYTDMuUlopm93fFy3_QfVhj9mijhOJc80ydb5SNYVki9vfD0Mocwzc5fHMM32zh544XD_9wz_-JOgOvN6Cd9v9V-wXMG7vX</recordid><startdate>20210629</startdate><enddate>20210629</enddate><creator>Hocker, Nathaniel</creator><creator>Story, Maria</creator><creator>Lerud, Alysa</creator><creator>Kuppachi, Sarat</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9360-4089</orcidid></search><sort><creationdate>20210629</creationdate><title>Severe hypercalcaemia from ectopic intact parathyroid hormone secretion treated with continuous renal replacement therapy in a patient with two malignancies</title><author>Hocker, Nathaniel ; 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| subjects | Abdomen Biopsy Calcium Carcinoma Cardiac arrhythmia Case Report Case reports Continuous Renal Replacement Therapy Creatinine Female Hemodialysis Humans Hypercalcemia Hypercalcemia - etiology Hypercalcemia - therapy Hyperplasia Hypotension Laboratories Liver cancer Metastasis Middle Aged Neuroendocrine tumors Ovaries Pancreas Pancreatic cancer Parathyroid Hormone Renal replacement therapy Thyroid gland Tumors Vagina Vitamin D |
| title | Severe hypercalcaemia from ectopic intact parathyroid hormone secretion treated with continuous renal replacement therapy in a patient with two malignancies |
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