Hypocalcemia in cancer patients

Öz

The primary objective of this review is to provide a concise summary and critical appraisal of the current literature on the differential diagnosis and management of hypocalcemia. Calcium plays a crucial role in muscle function and neurotransmitter release. However, hypocalcemia, defined as serum calcium levels below 8 mg/dL (2.12 mmol/L), can affect various organs and systems and lead to a range of clinical symptoms. This condition can range from being completely asymptomatic to life-threatening situations. Disorders responsible for hypocalcemia can be divided into two groups: those influenced by parathyroid hormone (PTH) and those not affected. In non-surgical and PTH-mediated forms, more comprehensive investigation is necessary to identify the underlying cause and determine appropriate treatment. In cases of acute hypocalcemia, intravenous calcium infusion is required to rapidly increase calcium levels and correct symptoms. On the other hand, treatment of chronic hypocalcemia generally involves oral calcium and/or vitamin D supplementation. In conclusion, this review specifically emphasizes iatrogenic (treatment-related) hypocalcemia while assessing the causes, dimensions, and management of hypocalcemia in cancer patients. Physicians' familiarity with these conditions is crucial in treatment management.

Anahtar Kelimeler

• Hypocalcemia
• hypomagnesemia
• cancer treatment
• chemotherapy
• cisplatin

Kanser hastalarında hipokalsemi

Öz

Bu derlemenin temel amacı, hipokalseminin ayırıcı tanısı ve yönetimi ile ilgili mevcut literatürün kısa bir özetini ve eleştirel bir değerlendirmesini sunmaktır. Kalsiyum, kas fonksiyonu ve nörotransmitter salınımında önemli bir rol oynar. Bununla birlikte, 8 mg/dL'nin (2,12 mmol/L) altındaki serum kalsiyum seviyeleri olarak tanımlanan hipokalsemi, çeşitli organ ve sistemleri etkileyebilir ve çeşitli klinik belirtilere yol açabilir. Bu tablo tamamen asemptomatik olabileceği gibi hayatı tehdit eden durumlara da yol açabilir. Hipokalsemiden sorumlu bozukluklar iki gruba ayrılabilir: paratiroid hormonundan (PTH) etkilenenler ve etkilenmeyenler. Cerrahi nedenlerden kaynaklanmayan ve PTH aracılı olmayan formlarda, altta yatan nedeni tanımlamak ve uygun tedaviyi belirlemek için daha kapsamlı bir araştırma gereklidir. Akut hipokalsemi vakalarında, intravenöz kalsiyum infüzyonu kalsiyum seviyelerini hızla artırmak ve semptomları düzeltmek gereklidir. Öte yandan, kronik hipokalsemi tedavisinde oral kalsiyum ve/veya D vitamini takviyesi genellikle yeterlidir. Sonuç olarak, bu derleme kanser hastalarında hipokalseminin nedenlerini, boyutlarını ve yönetimini değerlendirirken tedavi ilişkili (iatrojenik) hipokalsemiye özellikle vurgu yapmaktadır. Hekimlerin bu durumları iyi tanıması tedavi yönetiminde önemlidir.

Anahtar Kelimeler

• Hipokalsemi
• hipomagnezemi
• kanser tedavisi
• kemoterapi
• sisplatin

Kaynakça

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