Coming out of the hypercalcemic coma dramatically by applying iv pamidronate and sc calcitonin concomitant treatment which is due to very seldom etiology

The plasma calcium is maintained at a remarkably constant concentration by a complex homeostatic mechanism which is only partially understood. A multitude of cell and organ functions are dependent on the maintenance of the extracellular fluid calcium concentration within a very narrow range. Hypercalcemia is rarely a presenting sign of malignency, except in patients with parathyroid carcinoma, human T-cell lympotropic virus type-1 lymphoma, or multiple myeloma. In this article, a rarely occured coma of hypercalcemia due to very seldom etiology is presented and then coming out of the coma dramatically by applying IV Pamidronate and SC Calcitonin concomitant treatment and interesting clinic progress is explained.
Result: Clinicians are frequently confronted with hypercalcemia as an isolated laboratory abnormality. In practice 90 percent of cases are due either to primary hyperparathyroidism or to malignancy. Thus, the first two conditions that the clinician considers when faced with differential diagnosis of hypercalcemia is whether the underlying disorder responsible is malignancy or primary hyperparathyroidism.

Nadir etyolojili bir hiperkalsemi komasýndan pamidronat ve kalsitonin tedavisiyle çýkýþ

Kalsiyum dengesi yalnýzca bir kýsmý anlaþýlabilmiþ kompleks bir homeostatik mekanizma tarafýndan oldukça belirgin konsantrasyonda devam ettirilir. Hücre ve organ fonksiyonlarýnýn büyük bir çoðunluðu, ekstrasellüler sývý kalsiyum konsantrasyonunun çok dar sýnýrlar içinde devam ettirilmesine baðýmlýdýr. Malignitenin iþareti olarak lýiperkalseminin bulunmasý paratroid karsinomu, HTLV tip- I lenfoma veya multipl myeloma dýþýnda oldukça seyrektir. Bu makalede oldukça seyrek görülen bir etyolojiyle oluþan hiperkalsemi komasý olgusu sunulmuþ; ýýýtravenoýýs (IV) Panýidronat ve subcutaneus (SC) Kalsitonin ardýþýk tedavisi ile komadan dramatik bir þekilde çýkýþ ve ilginç klinik seyir anlatýlmýþtýr.
Sonuç: Klinisyenler hiperkalsemiyle sýkça izole bir laboratuar anormallik olarak karþýlaþýrlar. Pratikte bu nedenlerin %90’nmý primer hiperparatroidizný ve malignensi oluþturmaktadýr. Bundan dolayý klinisyenler hiperkalsemi ile karþýlaþtýklarýnda ilk önce bu iki nedeni araþtýrmalýdýr.