Hypercalcemia of malignancy: Difference between revisions
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==Background== | ==Background== | ||
===Causes=== | ===Causes=== | ||
*PTHrP release | |||
**SCC (particularly of the head and neck), breast renal, endometrial cancer | |||
*Local osteolysis | |||
**Associated primarily with bone mets | |||
**Multiple myeloma, lung, breast cancer | |||
*Production of vitamin D analogues | |||
**[[Lymphoma]] (Hodgkin) | |||
==Clinical Features== | ==Clinical Features== | ||
*See [[Hypercalcemia]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Diagnosis== | ==Diagnosis== | ||
*Chem10 | |||
*Ionized Ca | |||
*CBC | |||
*LFTs (alk phos, albumin) | |||
*ECG | |||
==Treatment== | ==Treatment== | ||
*See [[Hypercalcemia]] | |||
==Disposition== | ==Disposition== | ||
*Ca <12 | |||
**Home with f/u if oncology concurs | |||
*Ca>12 | |||
**Admit ward | |||
*ECG changes | |||
**Admit telemetry | |||
==See Also== | ==See Also== | ||
Revision as of 04:27, 25 June 2015
Background
Causes
- PTHrP release
- SCC (particularly of the head and neck), breast renal, endometrial cancer
- Local osteolysis
- Associated primarily with bone mets
- Multiple myeloma, lung, breast cancer
- Production of vitamin D analogues
- Lymphoma (Hodgkin)
Clinical Features
- See Hypercalcemia
Differential Diagnosis
Causes of Hypercalcemia
- Addison's disease
- Calciphylaxis
- Excess vitamin D
- Hypercalcemia of malignancy
- Hyperparathyroidism
- Hyperthyroidism
- Hypothyroidism
- Lithium
- Milk-alkali syndrome
- Paget disease
- Sarcoidosis
- Thiazide diuretics
Oncologic Emergencies
Related to Local Tumor Effects
- Malignant airway obstruction
- Bone metastases and pathologic fractures
- Malignant spinal cord compression
- Malignant Pericardial Effusion and Tamponade
- Superior vena cava syndrome
Related to Biochemical Derangement
- Hypercalcemia of malignancy
- Hyponatremia due to SIADH
- Adrenal insufficiency
- Tumor lysis syndrome
- Carcinoid syndrome
Related to Hematologic Derangement
Related to Therapy
- Chemotherapy-induced nausea and vomiting
- Cytokine release syndrome
- Chemotherapeutic drug extravasation
- Differentiation syndrome (retinoic acid syndrome) in APML
- Stem cell transplant complications
- Catheter-related complications
- Tunnel infection
- Exit site infection
- CVC obstruction (intraluminal or catheter tip thrombosis)
- Catheter-related venous thrombosis
- Fracture of catheter lumen
- Oncologic therapy related adverse events
Diagnosis
- Chem10
- Ionized Ca
- CBC
- LFTs (alk phos, albumin)
- ECG
Treatment
- See Hypercalcemia
Disposition
- Ca <12
- Home with f/u if oncology concurs
- Ca>12
- Admit ward
- ECG changes
- Admit telemetry