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Multifactorial hypercalcemia and literature review on primary hyperparathyroidism associated with lymphoma.
[familial hypocalciuric hypercalcemia]
The
most
common
cause
of
hypercalcemia
in
hospitalized
patients
is
malignancy
.
Primary
hyperparathyroidism
most
commonly
causes
hypercalcemia
in
the
outpatient
setting
.
These
two
account
for
over
90
%
of
all
cases
of
hypercalcemia
.
Hypercalcemia
can
be
divided
into
PTH
-mediated
and
PTH
-independent
variants
.
Primary
hyperparathyroidism
,
familial
hypocalciuric
hypercalcemia
,
familial
hyperparathyroidism
,
and
secondary
hyperparathyroidism
are
PTH
mediated
.
The
most
common
PTH
-independent
type
of
hypercalcemia
is
malignancy
related
.
Several
mechanisms
lead
to
hypercalcemia
in
malignancy-direct
osteolysis
by
metastatic
disease
or
,
more
commonly
,
production
of
humoral
factors
by
the
primary
tumor
also
known
as
humoral
hypercalcemia
of
malignancy
that
accounts
for
about
80
%
of
malignancy-related
hypercalcemia
.
The
majority
of
HHM
is
caused
by
tumor
-produced
parathyroid
hormone
-related
protein
and
less
frequently
production
of
1
,
25
-
dihydroxyvitamin
D
or
parathyroid
hormone
by
the
tumor
.
We
report
the
rare
case
of
a
patient
with
hypercalcemia
and
diagnosed
primary
hyperparathyroidism
.
The
patient
had
persistent
hypercalcemia
after
surgical
removal
of
parathyroid
adenoma
with
recorded
significant
decrease
in
PTH
level
.
After
continued
investigation
it
was
found
that
the
patient
also
had
elevated
1
,
25
-
dihydroxyvitamin
D
and
further
studies
confirmed
a
large
spleen
mass
that
was
later
confirmed
to
be
a
lymphoma
.
This
is
a
rare
example
of
two
concomitant
causes
of
hypercalcemia
requiring
therapy
.
Diseases
Validation
Diseases presenting
"common cause"
symptom
achondroplasia
acute rheumatic fever
adrenomyeloneuropathy
allergic bronchopulmonary aspergillosis
alpha-thalassemia
aniridia
aromatase deficiency
benign recurrent intrahepatic cholestasis
cadasil
child syndrome
coats disease
congenital adrenal hyperplasia
congenital toxoplasmosis
cushing syndrome
erdheim-chester disease
esophageal adenocarcinoma
esophageal squamous cell carcinoma
fabry disease
familial hypocalciuric hypercalcemia
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
lamellar ichthyosis
legionellosis
liposarcoma
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
pendred syndrome
primary hyperoxaluria type 1
pyruvate dehydrogenase deficiency
scrub typhus
systemic capillary leak syndrome
thoracic outlet syndrome
typhoid
von hippel-lindau disease
wiskott-aldrich syndrome
zellweger syndrome
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