What is humoral hypercalcemia of malignancy?

What is humoral hypercalcemia of malignancy?

Humoral hypercalcemia of malignancy (HHM) is caused by the oversecretion of parathyroid hormone-related peptide (PTHrP) from malignant tumors. Although any tumor may cause HHM, that induced by intrahepatic cholangiocarcinoma (ICC) or gastric cancer (GC) is rare.

How is humoral hypercalcemia of malignancy treated?

Thus, patients with hypercalcemia will generally need to be managed with urgency, and hypercalcemia of malignancy in many cases represents an oncologic emergency. The treatment options for hypercalcemia include IV hydration, calcitonin, bisphosphonates, denosumab, gallium nitrate, prednisone, and hemodialysis.

Which malignancy is most commonly associated with hypercalcemia?

The most common cancers associated with hypercalcemia in the United States are breast, renal, lung, and squamous cell cancers and multiple myeloma [2]. Malignancy is usually evident clinically by the time it causes hypercalcemia, and patients with hypercalcemia of malignancy often have a poor prognosis.

How does malignancy cause hypercalcaemia?

The pathophysiology of hypercalcemia of malignancy is mainly through three mechanisms: excessive secretion of parathyroid hormone-related protein (PTHrP), bony metastasis with the release of osteoclast activating factors, and production of 1,25-dihydroxy vitamin D (calcitriol).

What is the most common cause of hypercalcemia in dogs?

In hypercalcemic dogs, neoplasia (lymphosarcoma) is the most common cause, followed by hypoadrenocorticism, primary hyperparathyroidism, and chronic renal failure.

What humoral means?

Definition of humoral 1 : of, relating to, proceeding from, or involving a bodily humor (such as a hormone) 2 : relating to or being the part of immunity or the immune response that involves antibodies secreted by B cells and circulating in bodily fluids.

What are common signs and symptoms of hypercalcemia of malignancy?

Common signs and symptoms of mild hypercalcemia are anorexia and constipation. Higher degrees of hypercalcemia may also cause nausea, vomiting, weight loss (if chronic), and even pancreatitis or peptic ulcer disease (Dellay & Groth, 2016; Malangone & Campen, 2015; Mirrakhimov, 2015; Wijaya et al., 2014).

What is the first line treatment for hypercalcemia?

Intravenous bisphosphonates are the treatment of first choice for the initial management of hypercalcaemia, followed by continued oral, or repeated intravenous bisphosphonates to prevent relapse.

Is hypercalcemia in dogs treatable?

Although total serum calcium concentrations may be increased, the ionized fraction usually is normal. The hypercalcemia resolves quickly with successful treatment for hypoadrenocorticism.

Does lymphoma cause hypercalcemia in dogs?

In dogs, lymphoma is the most common cause of hypercalcemia -approximately 20% of affected dogs have serum cal- cium concentrations greater than l l . 5 mg/dl. ‘ the Donaldson-Atwood Cancer Clinic (Rosenberg, Matus) and the Department of Pathology (Patnaik), The Animal Medical Center, New York, New York.

Which condition is an example of humoral reaction?

Innate immunity also comes in a protein chemical form, called innate humoral immunity. Examples include the body’s complement system and substances called interferon and interleukin-1 (which causes fever). If an antigen gets past these barriers, it is attacked and destroyed by other parts of the immune system.

What does humoral mean in medicine?

What level of hypercalcemia is fatal?

Hypercalcemia is considered mild if the total serum calcium level is between 10.5 and 12 mg per dL (2.63 and 3 mmol per L). Levels higher than 14 mg per dL (3.5 mmol per L) can be life threatening.

What happens if hypercalcemia is left untreated?

If left untreated, hypercalcemia can lead to serious complications. For example, if the bones continue to release calcium into the blood, osteoporosis, a bone-thinning disease, can result. If urine contains too much calcium, crystals may form in the kidneys. Over time, these crystals may combine to form kidney stones.

How do you treat high calcium in dogs?

Pamidronate is the most commonly used parenteral drug; the recommended dosage in dogs is 1–2 mg/kg, IV, mixed in 0.9% saline given throughout 2 hr. In cats, alendronate is the most common oral preparation used to control idiopathic hypercalcemia.

What cancers cause high calcium levels in dogs?

The most common cause of a high calcium level is cancer. In about half of the cases of hypercalcemia in dogs the cause is lymphoma, a cancer of the lymphatic system. Lymphoma most often causes lymph nodes to swell, but it may localize in the liver, intestine, spleen, heart, brain, spinal cord, or kidneys.

What does it mean when a dogs calcium is high?

High calcium levels may signal the presence of serious underlying disease including kidney failure, adrenal gland failure (called Addison’s disease), a parathyroid gland tumor, and some types of cancer.

What are the two types of humoral immunity?

There are two types of humoral immunity: active and passive.

When is hypercalcemia an emergency?

Severe hypercalcemia (Ca>4 mmol/l or 16 mg/dl) is often considered an emergency because of a potential risk of cardiac arrest or coma 1–5.

What cancers cause high calcium levels?

High blood calcium levels sometimes happen if your cancer is advanced….The types of cancers that are most commonly associated with high blood calcium are:

• myeloma – about 30 in 100 people (about 30%) have high calcium when they are first diagnosed.
• breast cancer.
• lung cancer.
• kidney cancer.
• prostate cancer.