Pharmacologic Agents to Reverse Hypercalcemic and Hypocalcemic States

  • Robert J. Geller
  • James C. M. Chan
Part of the Developments in Nephrology book series (DINE, volume 11)


Calcium concentration in the extracellular fluids is precisely maintained within very narrow limits. Substantial deviations from the norm usually result in symptoms, such as tetany from hypocalcemia or anorexia, nausea, polydipsia, polyuria, constipation, depression, fatigue, muscle weakness and failure to thrive from hypercalcemia.


Serum Calcium Primary Hyperparathyroidism Calcium Gluconate Serum Calcium Concentration Total Serum Calcium 
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  1. 1.
    Corvisart, L.: These de Paris: De la contracture des extremites on tetamie chez l’adulte, 1852.Google Scholar
  2. 2.
    Cheadle, W. B.: Pathology and treatment of laryngismus tetany and convulsions, illustrated by cases of these disorders in childhood, and also by a case of the tetany of adult life. Lancet 1:919, 1887.CrossRefGoogle Scholar
  3. 3.
    Mundy, G. R. and Martin T. J.: The hypercalcemia of malignancy: pathogenesis and management. Metabolism 31:1247, 1982.PubMedCrossRefGoogle Scholar
  4. 4.
    Mannix, H.: Primary hyperparathyroidism in children. Am. J. Surg. 129:528, 1975.PubMedCrossRefGoogle Scholar
  5. 5.
    Bjernulf, A., Hall, K., Sjogren I. et al: Primary hyperparathyroidism in children. Acta. Ped. Scand. 59:249, 1970.CrossRefGoogle Scholar
  6. 6.
    Landing, B. H. and Kamoshita, S.: Congenital hyperparathyroidism secondary to maternal hypoparathyroidism. J. Pediatr. 77:842, 1970.PubMedCrossRefGoogle Scholar
  7. 7.
    Ibbotson, K. J., D’Souza, S. M., Kanis, J. A. et al: Physiological and pharmacological regulation of bone resorption. Metab. Bone Dis. Rel. Res 2:177, 1980.CrossRefGoogle Scholar
  8. 8.
    Stewart, A. F., Vignery, A., Silverglate, A., et al.: Quantitative bone histomorphometry in humoral hypercalcemia of malignancy: uncoupling of bone cell activity. J. Clin. Endocr. Metab. 55:219, 1982.PubMedCrossRefGoogle Scholar
  9. 9.
    Maynard, F. M. and Imai, K.: Immobilization hypercalcemia in spinal cord injury. Arch. Phys. Med. Rehabil. 58:16, 1977.PubMedGoogle Scholar
  10. 10.
    Hung, W., August, G. P., and Glasgow, A. M.: Parathyroids, calcium, and vitamin D. In Pediatric Endocrinology. New York: Medical Examination Publishing Company, 1978, p. 193.Google Scholar
  11. 11.
    Smith, D. W. and Jones, K. L.: Williams Syndrome. In Recognizable Patterns of Human Malformation. Philadelphia, W. B. Saunders, 1982, p. 100.Google Scholar
  12. 12.
    David, D. S., Sakai, S., Brennan, L. et al.: Hypercalcemia after renal transplantation: Long-term follow-up data. New Engl. J. Med. 289:398, 1973.Google Scholar
  13. 13.
    Conceicao, S. C., Wilkinson, R., Feest, T. G. et al.: Hypercalcemia following renal transplantation: causes and consequences. Clin. Nephrol. 16:235, 1981.PubMedGoogle Scholar
  14. 14.
    Elliott, G. T. and McKenzie, M. W.: Treatment of hypercalcemia. Drug Intell. Clin. Pharm. 17:12, 1983.PubMedGoogle Scholar
  15. 15.
    Ragavan, V. V., Smith, J. E. and Bilezikian, J. P.: Vitamin A toxicity and hypercalcemia. Am. J. Med. Sci. 283:161, 1982.PubMedCrossRefGoogle Scholar
  16. 16.
    Levine, R. A.: Risk of hypercalcemia from prophylaxis of Travelers’ Diarrhea. JAMA 249:1151, 1983.PubMedCrossRefGoogle Scholar
  17. 17.
    Orwoll, E. S.: The milk-alkali syndrome: current concepts. Ann. Int. Med. 97: 242, 1982.PubMedGoogle Scholar
  18. 18.
    Boyce, B. F., Fell, G. S., Elder, H. Y. et al.: Hypercalcemic osteomalacia due to aluminum toxicity. Lancet 2:1009, 1982.PubMedCrossRefGoogle Scholar
  19. 19.
    Tsang, R. C, Noguchi, A. and Steichen, J. J.: Pediatric parathyroid disorders. Ped. Clin. N. Am. 26:223, 1979.Google Scholar
  20. 20.
    Tsang, R. C, Chen, I., Friedman, M. A. et al.: Neonatal parathyroid function: Role of gestational age and postnatal age. J. Pediatr. 83:728, 1973.PubMedCrossRefGoogle Scholar
  21. 21.
    Rosenbloom, A. L.: Transient congenital idiopathic hypoparathyroidism. South. Med. J. 66:666, 1973.CrossRefGoogle Scholar
  22. 22.
    Hahn, T. J., Halstead, L. R. and Haddad, J. G.: Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid treatment. J. Lab. Clin. Med. 90:399, 1977.PubMedGoogle Scholar
  23. 23.
    Boyle, I. T. and Fogelman, I.: Glucocorticoids and estrogens in management of hypercalcemia. Metab. Bone Dis. Rel. Res. 2:203, 1980.CrossRefGoogle Scholar
  24. 24.
    Adinoff, A. D. and Hollister, J. R.: Steroid-induced fractures and bone loss in patients with asthma. N. Engl. J. Med. 309:265, 1983.PubMedCrossRefGoogle Scholar
  25. 25.
    Chan, J. C. M., Young, R. B., Mon, U. et al.: Hypercalcemia in children with disorders of calcium and phosphate during long-term treatment with 1,25-dihydroxyvitamin D3. Pediatr. 72:225, 1983.Google Scholar
  26. 26.
    Long, R. G., Wills, M.R. and Skinner, R. K.: Serum 25-hydroxyvitamin-D in untreated parenchymal and cholestatic liver disease. Lancet 2:650, 1976.PubMedCrossRefGoogle Scholar
  27. 27.
    Hunter, J., Maxwell, J. D., Stewart, D. A. et al.: Altered calcium metabolism in epileptic children on anticonvulsants. Br. Med. J. 4:202, 1971.PubMedCrossRefGoogle Scholar
  28. 28.
    Tolman, K. G., Jubiz, W., Sanella, J. J. et al.: Osteomalacia associated with anticonvulsant drug therapy in mentally retarded children. Pediatr. 56:45, 1975Google Scholar
  29. 29.
    Hahn, T. J. and Avioli, L. V.: Anticonvulsant osteomalacia. Arch. Int. Med. 135: 997, 1975.Google Scholar
  30. 30.
    Jubiz, W., Haussen, M. R., McCain, T. A. et al.: Plasma 1,25-dihydroxyvitamin D levels in patients receiving anticonvulsant drugs. J. Clin. Endocr. Metab. 44:617, 1977.PubMedCrossRefGoogle Scholar
  31. 31.
    Peterson, P., Gray, P. and Tolman, K. G.: Calcium balance in a drug induced osteomalacia: response to vitamin D. Clin. Pharm. Ther. 19:63, 1976.Google Scholar
  32. 32.
    Berger, R. E., Gomez, L. S. and Mallette, L. E.: Acute hypocalcemic effects of clinical contrast media injections. AJR 138:283, 1982.PubMedGoogle Scholar
  33. 33.
    Mallette, L. E. and Gomez, L. S.: Systemic hypocalcemia after clinical injections of radiographic contrast media: amelioration by omission of calcium chelating agents. Radiol. 147:677, 1983.Google Scholar
  34. 34.
    Pierce, W. M., Lineberry, M. D. and Waite, L. C: Effect of sulfonamides on the hypercalcemic response to vitamin D. Horm. Metab. Res. 14:670, 1982.PubMedCrossRefGoogle Scholar
  35. 35.
    Sleeboom, H. P. and Bijvoet, O. L. M.: Hypercalcemia due to malignancy: role of the kidney and treatment. Contr. Nephrol. 33:178, 1982.Google Scholar
  36. 36.
    Stewart, A. F.: Therapy of malignancy associated hypercalcemia. Am. J. Med. 74:475, 1983.PubMedCrossRefGoogle Scholar
  37. 37.
    Hosking, D. J.: Treatment of severe hypercalcemia with calcitonin. Metab. Bone Dis. and Rel. Res. 2:207, 1980.CrossRefGoogle Scholar
  38. 38.
    Avioli, L. R.: Calcitonin therapy for bone disease and hypercalcemia. Arch. Int. Med 142:2076, 1982.CrossRefGoogle Scholar
  39. 39.
    Mundy, G. R., Wilkinson, R. and Health, D. A.: Comparative study of available medical therapy for hypercalcemia of malignancy. Am. J. Med. 74:421, 1983.PubMedCrossRefGoogle Scholar
  40. 40.
    Binstock, M. L. and Mundy, G. R.: Effect of calcitonin and glucocorticoids in combination on the hypercalcemia of malignancy. Ann. Int. Med. 93:269, 1989.Google Scholar
  41. 41.
    Wisneski, L. A., Croom, W. P., Silva, O. L. et al.: Salmon calcitonin in hypercalcemia. Clin. Pharm. Ther. 24:219, 1978.Google Scholar
  42. 42.
    Coombes, R. C, Dady, P., Parsons, C. et al.: Mithramycin therapy: an adjunct to conventional treatment of hypercalcemia and bone metastases in breast cancer. Metab. Bone Dis. and Rel. Res. 2:199, 1980.CrossRefGoogle Scholar
  43. 43.
    Strumpf, M., Kowalski, M. A. and Mundy, G. R.: Effects of glucocorticoids on osteoclast activating factor. J. Lab. Clin. Med. 92:272, 1978.Google Scholar
  44. 44.
    Heath, D. A.: The use of inorganic phosphate in the management of hypercalcemia. Metab. Bone Dis. and Rel. Res. 2:213, 1980.CrossRefGoogle Scholar
  45. 45.
    Martin, T. J. and Partridge, N. C: Prostaglandins, cancer and bone: pharmacological considerations. Metab. Bone Dis. and Rel. Res. 2:167, 1980.CrossRefGoogle Scholar
  46. 46.
    Baker, J. R. and Wray, H. L.: Early management of hypercalcemic crisis: case report and literature review. Milit. Med. 147:756, 1982.Google Scholar
  47. 47.
    Wills, M. R., Bruns, D. E. and Savory, J.: Disorders of calcium homeostasis in the fetus and neonate. Ann. Clin. Lab. Sci 12:79, 1982.PubMedGoogle Scholar
  48. 48.
    Parfitt, A. M.: Surgical, idiopathic and other varieties of parathyroid hormone deficient hypoparathyroidism. In DeGroot LJ, LaHill GF Jr, Odell WD, Martini L, Potts JT Jr, Nelson DH, Steinberger E, Winegred AI (eds): Endocrinology. New York: Grune & Stratton, Inc., 1979.Google Scholar
  49. 49.
    Beale, M. G., Chan, J. C. M., Oldham, S. B. et al: Vitamin D: The discovery of its metabolites and their therapeutic applications. Pediatr. 57:729, 1976.Google Scholar
  50. 50.
    Mazzuoli, G. F., Coen, C. and Antonozzi, I.: Study on calcium metabolism, thyro-calcitonin assay and effect of thyroidectomy in pseudohypoparathyroidism. Int. J. Med. Sci. 3:627, 1967.Google Scholar
  51. 51.
    Drezner, M. K., Neelon, F. A., Haussier, M. et al: 1,25-dihydroxycholecalciferol deficiency: The probable cause of hypocalcemia and metabolic bone disease in pseudohypoparathyroidism. J. Clin. Endocrinol. Metab. 42:621, 1976.PubMedCrossRefGoogle Scholar
  52. 52.
    Kooh, W. W., Fraser, D., DeLuca, H. F. et al: Treatment of hypoparathyroidism and pseudohypoparathyroidism with metabolites of vitamin D. Evidence for impaired conversion of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D. N. Engl. J. Med. 293:840, 1973.CrossRefGoogle Scholar
  53. 53.
    Alon, U., Wellons, M. D. and Chan, J. C. M.: Reversal of vitamin-D-induced hypercalciuria by chlorothiazide. Pediatr. Res. 17:117, 1983.PubMedCrossRefGoogle Scholar
  54. 54.
    Suh, S. M., Tashjian, A. H. and Mutuso, N.: Pathogenesis of hypocalcemia in primary hypomagnesemia: Normal end-organ responsiveness to parathyroid hormone, impaired parathyroid gland function. J. Clin. Invest. 52:153, 1973.PubMedCrossRefGoogle Scholar
  55. 55.
    Harrison, H. E. and Harrison, H. C: In Disorders of Calcium and Phosphate Metabolism in Childhood and Adolescence. Philadelphia: W. B. Saunders Co., 1979, p. 314.Google Scholar
  56. 56.
    Alon, U. and Chan, J. C. M.: Calcium and Vitamin-D homeostasis in the nephrotic syndrome. Nephron 36:1, 1984.PubMedCrossRefGoogle Scholar
  57. 57.
    Alon, U. and Chan, J. C. M.: Calcium and vitamin-D metabolism in nephrotic syndrome. Int. J. Pediatr. Nephrol. 4:115, 1983.PubMedGoogle Scholar

Copyright information

© Martinus Nijhoff Publishing, Boston 1986

Authors and Affiliations

  • Robert J. Geller
  • James C. M. Chan

There are no affiliations available

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