Oct 24, 2018
Author: Rachel Brady, MD
Educational Pearls:
Hypercalcemia of malignancy:
- Hypercalcemia of malignancy can present with lethargy, muscle weakness, hyperreflexia, altered mental status, cardiac dysrhythmias, and even cardiac arrest.
- Treatment is based both on calcium level and symptoms
- Intravenous rehydration is first line treatment
- Other options include steroids, bisphosphonates and calcitonin.
Tumor Lysis Syndrome
- Occurs due to the breakdown of tumor cells after chemotherapy/radiation
- Presents as hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia
- Treatment is very similar to severe hypercalcemia - hydration with crystalloids
- Hyperuricemia can be treated using rasburicase or allopurinol
References:
Ñamendys-Silva SA, Arredondo-Armenta JM, Plata-Menchaca EP, Guevara-García H, García-Guillén FJ, Rivero-Sigarroa E, Herrera-Gómez A. Tumor lysis syndrome in the emergency department: challenges and solutions. Open Access Emerg Med. 2015 Aug 20;7:39-44. doi: 10.2147/OAEM.S73684. eCollection 2015. Review. PubMed PMID: 27147889; PubMed Central PMCID: PMC4806807.
Zagzag J, Hu MI, Fisher SB, Perrier ND. Hypercalcemia and cancer: Differential diagnosis and treatment. CA Cancer J Clin. 2018 Sep;68(5):377-386. doi: 10.3322/caac.21489. Epub 2018 Sep 21. Review. PubMed PMID: 30240520.
Summary by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD