The hypercalcemias are a common and heterogeneous group of disorders, ranging from the occasional detection of a high level of serum calcium to a life-treating condition. In a patient presenting with hypercalcemia, a ...The hypercalcemias are a common and heterogeneous group of disorders, ranging from the occasional detection of a high level of serum calcium to a life-treating condition. In a patient presenting with hypercalcemia, a differential diagnosis can be established easily by measuring serum calcium and parathyroid hormone(PTH) concentrations. We describe the case of an 83-year-old man presenting with a severe symptomatic hypercalcemia with high-normal PTH level due to the coexistence of primary hyperparathyroidism and malignancy-associated hypercalcemia. The presence of two conditions producing hypercalcemia was revealed only during inhospital stay and after the administration of an intravenous bisphosphonate, when the PTH concentration increased rapidly after bisphosphonate treatment with a decrease in serum calcium. The occurrence of twoconditions producing hypercalcemia is a rare event in the literature, and should be considered in the presence of an abnormally high serum calcium level associated with normal or high-normal PTH, in order to establish a correct diagnosis and appropriate interventions.展开更多
Paraneoplastic syndromes (PS) represent a large spectrum of symptoms, associated with malignant diseases. PS can be diagnosed in asymptomatic patients with occult carcinoma, clinically active cancer, and during clinic...Paraneoplastic syndromes (PS) represent a large spectrum of symptoms, associated with malignant diseases. PS can be diagnosed in asymptomatic patients with occult carcinoma, clinically active cancer, and during clinical remission, suggesting a recurrence of the neoplasm. The underlying mechanisms of PS are not completely understood but several authors have suggested that the increased production of biologically active immune factors and cytokines from the neoplastic cells may underlie the etiology of PS. Although rare, the renal involvement of patients with prostatic carcinoma has been reported. The most common paraneoplastic-associated glomerulopathy in prostatic cancer is the membranoproliferative glomerulonephritis with nephrotic syndrome (NS). In this review, we aimed to discuss the incidence of nephrotic syndrome secondary to prostatic carcinoma, its challenging diagnosis, clinical manifestation, and treatment.展开更多
文摘The hypercalcemias are a common and heterogeneous group of disorders, ranging from the occasional detection of a high level of serum calcium to a life-treating condition. In a patient presenting with hypercalcemia, a differential diagnosis can be established easily by measuring serum calcium and parathyroid hormone(PTH) concentrations. We describe the case of an 83-year-old man presenting with a severe symptomatic hypercalcemia with high-normal PTH level due to the coexistence of primary hyperparathyroidism and malignancy-associated hypercalcemia. The presence of two conditions producing hypercalcemia was revealed only during inhospital stay and after the administration of an intravenous bisphosphonate, when the PTH concentration increased rapidly after bisphosphonate treatment with a decrease in serum calcium. The occurrence of twoconditions producing hypercalcemia is a rare event in the literature, and should be considered in the presence of an abnormally high serum calcium level associated with normal or high-normal PTH, in order to establish a correct diagnosis and appropriate interventions.
文摘Paraneoplastic syndromes (PS) represent a large spectrum of symptoms, associated with malignant diseases. PS can be diagnosed in asymptomatic patients with occult carcinoma, clinically active cancer, and during clinical remission, suggesting a recurrence of the neoplasm. The underlying mechanisms of PS are not completely understood but several authors have suggested that the increased production of biologically active immune factors and cytokines from the neoplastic cells may underlie the etiology of PS. Although rare, the renal involvement of patients with prostatic carcinoma has been reported. The most common paraneoplastic-associated glomerulopathy in prostatic cancer is the membranoproliferative glomerulonephritis with nephrotic syndrome (NS). In this review, we aimed to discuss the incidence of nephrotic syndrome secondary to prostatic carcinoma, its challenging diagnosis, clinical manifestation, and treatment.
