Section of Specialized Endocrinology, Division of Medicine, Oslo University Hospital, Norway; Faculty of Medicine, University in Oslo, Oslo, Norway.
Section of Specialized Endocrinology, Division of Medicine, Oslo University Hospital, Norway; Faculty of Medicine, University in Oslo, Oslo, Norway.
Best Pract Res Clin Endocrinol Metab. 2018 Oct;32(5):621-638. doi: 10.1016/j.beem.2018.06.005. Epub 2018 Jun 18.
Parathyroid independent hypercalcemia is characterized by suppressed parathyroid hormone (PTH) in the presence of hypercalcemia. Well known causes and mechanisms are redistribution of calcium from the skeleton, by malignant diseases; inadequately increased intestinal calcium uptake mediated by increased vitamin D activity, and reduced renal elimination due to medications. Frequent and infrequent causes are discussed, and more recent mechanistic models presented in this review. Most hypercalcemic conditions are stable and in equilibrium between the different organs, whereas the utmost severe cases are characterized by rapid rising calcium levels and renal failure, resulting in a vicious circle where a disequilibrium state is developed. Management and treatment depends on the underlying condition and severity. The aim of this review is to discuss non-parathyroid hypercalcemic conditions as seen in the modern clinic, with a focus on areas where recent gain of knowledge has been achieved.
甲状旁腺无关性高钙血症的特征是在高钙血症的情况下甲状旁腺激素 (PTH) 受到抑制。众所周知的原因和机制是钙从骨骼中的重新分布，由恶性疾病引起；维生素 D 活性增加导致肠道钙吸收不足，以及药物导致肾脏排泄减少。本文讨论了常见和罕见的原因，并介绍了该领域最近提出的机制模型。大多数高钙血症情况在不同器官之间处于稳定和平衡状态，而在最严重的情况下，钙水平迅速上升并伴有肾衰竭，导致失衡状态的形成。管理和治疗取决于潜在的疾病和严重程度。本文的目的是讨论现代临床中所见的非甲状旁腺性高钙血症情况，重点介绍最近在这些领域取得的知识进展。
