ABSTRACT
Although hypercalcaemia is often encountered during the course of malignant disease, hypocalcaemia appears to be rather rare. We describe a 37-year-old patient with metastatic carcinoma of the breast, who developed extreme hypocalcaemia (as low as 0.75 mmol calcium per litre) after chemotherapy. This is caused by a combination of hungry-bone syndrome and an insufficient parathyroid response. The latter may be the result of a direct toxic effect of chemotherapy on parathyroid hormone (PTH) synthesis possibly in combination with microscopic tumour infiltration in the parathyroid glands. Correction of the extreme hypocalcaemia over a period of 100 days by oral and intravenous calcium supplementation, corresponding to a total of 352 gram elemental calcium (1/3 of the total body calcium), resulted in gradual symptomatic relief. The possible mechanisms for these findings are discussed and the literature is briefly reviewed.
Subject(s)
Bone Neoplasms/secondary , Breast Neoplasms/pathology , Hypocalcemia/etiology , Parathyroid Hormone/blood , Adult , Bone Neoplasms/complications , Female , Humans , Hypocalcemia/blood , Hypocalcemia/therapySubject(s)
Cryoglobulinemia/complications , Cryoglobulins/chemistry , Sjogren's Syndrome/complications , Aged , Aged, 80 and over , Hot Temperature , Humans , Male , Prednisolone/therapeutic use , Pulmonary Fibrosis/diagnosis , Pulmonary Fibrosis/etiology , Sjogren's Syndrome/blood , Sjogren's Syndrome/drug therapy , SolubilitySubject(s)
Cryoglobulinemia/complications , Glomerulonephritis, Membranoproliferative/etiology , Cryoglobulinemia/classification , Cryoglobulinemia/drug therapy , Female , Glomerulonephritis, Membranoproliferative/drug therapy , Glomerulonephritis, Membranoproliferative/physiopathology , Humans , Middle Aged , Time FactorsABSTRACT
We demonstrate a case with 17 alpha-hydroxylase deficiency that presented in an unusual way. The steroid metabolism and diagnostic procedures are discussed.
Subject(s)
Adrenal Hyperplasia, Congenital , Hypertension/etiology , Adult , Chronic Disease , Female , Humans , Hypertension/enzymology , Hypertension/genetics , Nuclear FamilyABSTRACT
Kindling stimulations were applied to the Schaffer collateral/commissural fibers in the CA1 area of the dorsal rat hippocampus. In fully kindled animals the ultrastructural distribution of calcium was studied at different time intervals after an induced generalized seizure, using the oxalate-pyro-antimonate technique. Semi-quantitative analysis of the amount of precipitate revealed no change in the investigated structures analysed after 2 h or 24 h: boutons and spines of the Schaffer-collateral/pyramidal-dendrite synaptic contacts, cytoplasm and mitochondria of terminals on pyramidal cell bodies and smooth dendrites. The major change was found 15 min after a seizure, when calcium precipitate in boutons and spines of stratum radiatum was strongly increased, precipitate in somata terminals only slightly, while smooth dendrites were not affected. These results imply a seizure-related increase of the intracellular calcium concentration. The transient character suggests that the investigated cellular compartments in kindled tissue are still capable of maintaining calcium homeostasis. The observed increase in precipitate density for at least 15 min may initiate the neurochemical mechanisms leading to an enhanced seizure sensitivity in the kindling model of epilepsy.
