Too much calcium in the blood

Introduction The normal value of blood calcium is 9-11 mg of calcium in 100 ml of blood, which is 2.2-2.7 mmol per liter of blood. The normal fluctuation of blood calcium is small, mainly because calcium is extremely important for maintaining various physiological functions of the human body. The possibility of various diseases can be judged by the detection of blood calcium ions. For example, when the parathyroid gland is hyperactive, the blood ion calcium is higher than the normal range.

Cause

Causes of excessive calcium in the blood

The etiology of primary hyperparathyroidism is unclear. The possible causes are as follows:

1, head and neck radiation therapy: 10%-30% of parathyroidism patients have a history of radiation therapy, and often have thyroid nodular disease. Among them, benign thyroid diseases account for 20%-50%, and malignant lesions are 6%-11%.

2, alcoholism.

3, drugs: thiazide diuretics, glucocorticoids, thiouracil, glucagon, etc. can lead to increased PTH.

4. Inheritance: There may be more than one member in a family with hyperthyroidism, some multiple endocrine adenomas, (MEN), MEN I refers to multiple endocrine neoplasia of pituitary, pancreatic, parathyroid, adrenal cortex, Deletion of the second pair of chromosome q13 alleles. MEN II is a parathyroid hyperplasia with medullary thyroid tumors or / and pheochromocytoma, with 10 pairs of chromosome defects.

an examination

Examination of excessive calcium in the blood

Serum calcium: Hypercalcemia is the most important biochemical indicator of this disease, the most diagnostic value. If only measured once, only 1/2 of the patients presented. There are many patients who need to repeat several tests in the same laboratory to find out. Blood calcium >2.6mmol / l can be diagnosed with high blood calcium.

Clinical manifestation

1, bone and joint damage: systemic diffuse bone disease, mostly bones with gravity, the following limbs, lumbar vertebrae, plantar disease is the most common, increased after the activity. During the physical examination, there may be tenderness in the long bones, and spontaneous fractures may occur, especially in the cystic lesions, which occur in the long bones and occasionally in the mandible. Joint pain, caused by subchondral fracture or erosive arthritis, is easily misdiagnosed as a wind-like condition.

2, urinary system: about 2 / 3 patients may have kidney damage, common recurrent urinary tract stones, renal colic, hematuria, especially in patients with bilateral urinary calculi, about 5% -10% of the disease because of this disease. Decreased renal tubular concentrating function produces polyuria, polydipsia, and increased blood calcium, and severe urine collapse. Renal tubular structure destruction is prone to repeated urinary tract infections, which ultimately leads to a decrease in nephron and an irreversible renal failure.

3. Digestive system: High blood calcium reduces the excitability of smooth muscle and reduces the gastrointestinal tension. The patient has indigestion, anorexia, nausea, vomiting and constipation. PTH can increase gastrin secretion by about 10%, may be associated with recurrent peptic ulcer, and drug treatment is ineffective. After removal of the parathyroid adenoma, it can be cured. Calcium ions are easily deposited in the sacral pancreatic duct and pancreas, and trypsin is activated to cause acute and chronic pancreatitis in 5%-10% of patients.

4, cardiovascular system: high blood pressure vascular smooth muscle contraction, vascular calcification, the formation of high blood pressure, the incidence of 20% -25%, endocardial and myocardial calcification to reduce cardiac function.

5, neuropsychiatric lesions: when blood calcium 3-4, there are symptoms of mental weakness. At 4 o'clock, there was an organic psychosis, and there was paralysis and insanity. When I was close to 5, I was unconscious. A few have headaches, strokes, extracorporeal lesions, paralysis, and may be related to intracranial calcification.

6, muscle system: muscle weakness, proximal muscle group susceptible, proximal muscle pain, atrophy, muscle biopsy showed non-specific changes. Electromyography can be reported as myogenic or neurogenic and can be misdiagnosed as peripheral neuritis.

Laboratory examination: first qualitative and post-positioning, when there is biochemical changes, then image examination to locate the diagnosis.

Differential diagnosis

Symptoms of high calcium levels in the blood

Hyperparathyroidism should be differentiated from all diseases that can cause osteoporosis or softening in children, such as renal bone disease, hypophosphatase, infant hypercalcemia, and hepatolenticular degeneration. The main identification points are: attention to blood, urinary calcium, phosphorus, phosphatase and blood, urine related metals such as copper. Special attention should also be paid to the characteristic changes in hyperparathyroidism, such as subcortical and subchondral cortical bone resorption, and fibrocystic osteitis (brown tumor). In addition, attention should also be paid to the occurrence of urinary calculi and ectopic soft tissue calcification, and sometimes it should be differentiated from vitamin D deficiency rickets and even myeloma and bone lymphoma.

Serum calcium: Hypercalcemia is the most important biochemical indicator of this disease, the most diagnostic value. If only measured once, only 1/2 of the patients presented. There are many patients who need to repeat several tests in the same laboratory to find out. Blood calcium >2.6mmol / l can be diagnosed with high blood calcium.

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