Neth J Med 2017 Jun;75(5):208-210

Department of Internal Medicine 3 - Haematology and Oncology, Kepler University Hospital, Linz, Austria.

We report a case of a 48-year-old female patient with newly diagnosed multiple myeloma. She developed recurrent torsade de pointes and required cardiopulmonary resuscitation and defibrillation. Atrial arrhythmias in patients with multiple myeloma and hypercalcaemia have been described, but, to the best of our knowledge, this is the first report of torsade de pointes in this setting. Read More

In Vivo 2017 Jul-Aug;31(4):769-771

Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.

Background/aim: Rapid progressive disease (RPD), accelerated tumour growth immediate after the initiation of immune checkpoint inhibitor therapy, has been reported in melanoma and lung cancer. Herein, we describe 3 cases of RPD during the initial phase of nivolumab treatment for metastatic renal cell carcinoma.

Patients And Methods: The first and second patients received nivolumab in the fourth-line setting. Read More

Korean J Intern Med 2017 Jun 26. Epub 2017 Jun 26.

Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Background/aims: Although multiple myeloma (MM) is typically a disease of the elderly, a certain subset of extremely young patients exists. It is necessary to establish clinicopathological characteristics for this population.

Methods: We reviewed the medical records of MM patients whose age was 40 years or younger at diagnosis. Read More

Horm Res Paediatr 2017 Jun 23. Epub 2017 Jun 23.

Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.

Background: Vitamin D supplementation is widely recommended for infants, but the optimal dose remains unclear. High intake may result in hypercalcemia.

Methods: We evaluated the incidence of hypercalcemia during the first year of life in a cohort of 987 healthy children who received 10 or 30 μg of vitamin D3 supplementation daily. Read More

Curr Osteoporos Rep 2017 Jun 22. Epub 2017 Jun 22.

Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Building 30 Room 228 MSC 4320, Bethesda, MD, 20982, USA.

Purpose Of Review: Denosumab is an inhibitor of receptor activator of nuclear factor kappa-B ligand (RANKL), and has emerged as an important novel therapy for skeletal disorders. This article examines the use of denosumab in children.

Recent Findings: Considerable safety and efficacy data exists for denosumab treatment of adults with osteoporosis, bone metastases, and giant cell tumors. Read More

Jpn J Radiol 2017 Jun 21. Epub 2017 Jun 21.

Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa, 241-0811, Japan.

Primary hyperparathyroidism (pHPT) causes hypercalcemia. The treatment for pHPT is surgical dissection of the hyperfunctioning parathyroid gland. Lower rates of hypocalcemia and recurrent laryngeal nerve injury imply that minimally invasive parathyroidectomy (MIP) is safer than bilateral neck resection. Read More

Horm Metab Res 2017 Jun 21. Epub 2017 Jun 21.

Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.

Nephrology (Carlton) 2017 Jul;22(7):572-573

Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan.

J Endocrinol Invest 2017 Jun 15. Epub 2017 Jun 15.

Endocrine Unit 2, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Nephrology (Carlton) 2017 Jun 15. Epub 2017 Jun 15.

The Canberra Hospital Renal Unit.

Aim: To assess the efficacy, safety and calcium balance of a membrane based regional citrate anticoagulation plasma exchange protocol METHODS: This was an observational, prospective, single center study of membrane separation plasma exchange using regional citrate anticoagulation. It was performed using a fixed dose pre-filter citrate infusion that was based on the plasma flow rate. Patients received a post filter calcium infusion which was modified during treatment based on systemic ionized calcium monitoring. Read More

Clin Kidney J 2017 Jun 7;10(3):411-418. Epub 2017 Jan 7.

Department of Nephrology and Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Background: Renal transplant recipients (RTRs) are often Vitamin D (VitD) depleted as a result of both chronic kidney disease and mandated sun avoidance behaviours. Repleting VitD may be warranted, but how, and for how long, is unknown, as is the impact of seasonality on the success of repletion. We investigated the impact of seasonality on VitD status following VitD repletion in a large cohort of stable, long-term RTRs. Read More

Scand J Clin Lab Invest 2017 Jun 14:1-6. Epub 2017 Jun 14.

a Department of Medical Sciences , Clinical Chemistry, Uppsala University , Uppsala , Sweden.

Background: There is a longstanding controversy as to whether plasma measurements of total calcium should be adjusted for albumin concentration, and if so which formulas are the most appropriate.

Methods: Ionised calcium, total calcium and albumin results, analysed at the same time at Uppsala University Hospital Laboratory between February 2005 and June 2013, were retrieved from a laboratory information system. The dataset included results from 20,003 patients. Read More

Chemotherapy 2017 Jun 13;62(6):327-333. Epub 2017 Jun 13.

Zoledronic acid is an established agent used in the management of metastatic bone disease. The administration of zoledronic acid improves overall survival (OS) of lung cancer patients with bone metastases receiving chemotherapy. However, it is currently unknown whether zoledronic acid-induced fever is associated with OS. Read More

Curr Opin Pulm Med 2017 Jun 8. Epub 2017 Jun 8.

aDepartment of Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio, ISA bDepartment of Pulmonary Medicine, Corfu General Hospital, Corfu c2nd Pulmonary Department, ATTIKON University Hospital, Athens, Greece.

Purpose Of Review: Vitamin D supplementation is widespread used in the general population. In sarcoidosis, up to 50% of patients, especially postmenopausal women and those taking corticosteroids, show evidence of increased bone fragility. The purpose of this review is to provide an evidence-based rationale on how to treat sarcoidosis patients with bone health issues. Read More

JNMA J Nepal Med Assoc 2017 Jan-Mar;56(205):182-185

Department of Pediatrics & Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.

Hypercalcemia is a rare metabolic disorder associated with hyperparathyroidism, malignancy and various other causes. Although common in adult malignancies, hypercalcemia is rare in pediatrics and purports poor prognosis. Nasopharyngeal carcinoma is rare with no reported hypercalcemic presentation. Read More

Eur J Orthop Surg Traumatol 2017 Jun 8. Epub 2017 Jun 8.

Second Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, Attikon University General Hospital, 41 Ventouri Street, Holargos, 15562, Athens, Greece.

Skeletal-related events in patients with metastatic bone disease include intractable severe pain, pathologic fracture, spinal cord and nerve compression, hypercalcemia and bone marrow aplasia. In patients with breast cancer, the skeleton is the most frequent site for metastases. Treatment options for metastatic bone disease in these patients include bisphosphonates, chemotherapeutic agents, opioids, hormonal therapy, minimally invasive/interventional and surgical techniques. Read More

Oncotarget 2017 May 18. Epub 2017 May 18.

Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA.

Whether vitamin D is chemopreventive and/or has potential therapeutically in prostate cancer is unresolved. One confounding factor is that many prostate cancers express a TMPRSS2:ERG fusion gene whose expression is increased both by androgens and by vitamin D receptor (VDR) activation. Two challenges that limit VDR agonist use clinically are hypercalcemia and the cooperation of VDR with ERG to hyper-induce the 1α,25-dihydroxyvitamin D3 metabolizing enzyme, CYP24A1, thus reducing VDR activity. Read More

Clin Adv Hematol Oncol 2017 Apr;15(4):285-295

Harvard Medical School, Boston, Massachusetts.

Bone involvement manifesting as osteolytic bone disease (OBD) or osteopenia is one of the defining features of multiple myeloma (MM). Osteolytic lesions develop in nearly 90% of patients with MM, and these are frequently complicated by skeleton-related events (SREs) such as severe bone pain, pathologic fractures, vertebral collapse, hypercalcemia, and spinal cord compression. SREs have a negative effect on patients' quality of life and affect their long-term outcomes, including survival. Read More

Ann Neurosci 2017 May 12;24(2):82-89. Epub 2017 May 12.

The Clinical Neuroscience Laboratory, Faculty of Medicine of Fez, University Hospital of Fez, Fez, Morocco.

Background: Various alterations of hypothalamic-pituitary-adrenal axis function have been described in patients with chronic renal failure. Nevertheless, controversial evidences were stated about the association between adrenal function deficiency (AD) and hemodialysis (HD).

Purpose: The goal of this paper was to estimate indirect indices of the adrenal gland dysfunction which is potentially influenced by oxidative stress (OS) that still generates brain plasticity and reorganization of the functional control. Read More

An Pediatr (Barc) 2017 Jun 3. Epub 2017 Jun 3.

Servicio de Neonatología, Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid, Red SAMID del Instituto Carlos III, Instituto de Investigación Hospital Universitario 12 de Octubre, Madrid, España.

Objective: To determine the frequency and magnitude of neonatal hypophosphataemia (<4mg/dL) in a neonatal Intensive Care Unit and to describe risk groups.

Patients And Methods: Retrospective study of hospitalised newborns over a 44 month period (phase 1). Retrospective study of <1,500g/<32 weeks of gestation newborns over a 6 month period (phase 2). Read More

Magy Onkol 2017 Jun 23;61(2):175-180. Epub 2016 Jul 23.

Onkológia, XV. ker. Egészségügyi Intézményei, Budapest, Hungary.

Some disseminated tumor cells (as "seeds") feel well in the skeletal tissue, as a "soil", but the humoral crosstalk between tumor cells and bone cells disrupts the normal bone homeostasis (remodeling), which leads to a vicious circle, the multiple bone metastatic disease. The tumor cells could stimulate bone resorption, bone neo-formation or both, characteristic of the primary tumor. This usually incurable condition involves serious consequences, as fractures, pain, surgeries, irradiations, plegias, hypercalcemia, etc. Read More

Drugs 2017 Jun 5. Epub 2017 Jun 5.

Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee, Memphis, USA.

As kidney disease progresses, phosphorus retention also increases, and phosphate binders are used to treat hyperphosphatemia. Clinicians prescribe phosphate binders thinking that reducing total body burden of phosphorus may decrease risks of mineral and bone disorder, fractures, cardiovascular disease, progression of kidney disease, and mortality. Recent meta-analyses suggest that sevelamer use results in lower mortality than use of calcium-containing phosphate binders. Read More

Leuk Res 2017 May 31;59:75-84. Epub 2017 May 31.

Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK; NIHR BRC Blood Theme, Oxford, UK.

Multiple myeloma (MM) is a progressive plasma cell malignancy, with a range of clinical features including bone lesions, renal insufficiency, anaemia, and hypercalcaemia. Novel agents have significantly improved patient survival, however most patients will suffer multiple relapses. Although clinical challenges and economic costs of relapse are recognised, the psychological impact of relapse is not fully appreciated. Read More

Ginekol Pol 2017 ;88(5):270-275

Department of Endocrinology, Metabolism and Internal Medicine, University of Medical Sciences, Poznan, Poland.

Hyperparathyroidism during pregnancy is diagnosed in 0.5-1.4% women and poses a serious challenge. Read More

Case Rep Endocrinol 2017 10;2017:7012520. Epub 2017 May 10.

Department of Endocrinology and Metabolism, Nagoya City West Medical Center, 1-1-1 Hirate-cho, Kita-ku, Nagoya 462-8508, Japan.

Humoral hypercalcemia of malignancy (HHM) is caused by the oversecretion of parathyroid hormone-related peptide (PTHrP) from malignant tumors. Although any tumor may cause HHM, that induced by intrahepatic cholangiocarcinoma (ICC) or gastric cancer (GC) is rare. We report here a 74-year-old male who displayed HHM with both ICC and GC and showed an elevated serum PTHrP level. Read More

Clin Med (Lond) 2017 Jun;17(3):270-273

Department of Diabetes & Endocrinology, Norfolk and Norwich University Hospital; Norwich Medical School; NIHR CRN:Eastern Research Network, Norwich, UK.

Hypercalcaemia is a common disorder normally caused by primary hyperparathyroidism (PHPT) or malignancy. A proportion of cases present as an emergency, which carries a significant mortality. Emergency management of hypercalcaemia is based on intravenous rehydration with normal saline but when this is inadequate, bisphosphonate therapy is used; more recently the novel anti-resorbtive agent denosumab has been shown to have a useful role in treatment. Read More

Med Hypotheses 2017 Jun 26;103:100-104. Epub 2017 Apr 26.

Diabetes and Endocrinology, Thomas Addison Unit, St George's Healthcare NHS Trust, London, UK. Electronic address:

Primary hyperparathyroidism (PHPT) is present in up to 0.1% of the general population. The incidence is higher in women and increases with age. Read More

Continuum (Minneap Minn) 2017 Jun;23(3, Neurology of Systemic Disease):778-801

Purpose Of Review: This article provides an overview of endocrine emergencies with potentially devastating neurologic manifestations that may be fatal if left untreated. Pituitary apoplexy, adrenal crisis, myxedema coma, thyroid storm, acute hypercalcemia and hypocalcemia, hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state), and acute hypoglycemia are discussed, with an emphasis on identifying the signs and symptoms as well as diagnosing and managing these clinical entities.

Recent Findings: To identify the optimal management of endocrine emergencies, using formal clinical diagnostic criteria and grading scales such as those recently proposed for pituitary apoplexy will be beneficial in future prospective studies. Read More

Harefuah 2017 Feb;156(2):71-73

Department of Ophthalmology, Kaplan Medical Center, Rehovot.

Introduction: Bisphosphonates are a group of drugs used for treatment in several bone diseases such as osteoporosis in women, Paget's disease, hypercalcemia of malignancy, primary malignancies of the bone and metastatic bone disease (breast and prostate carcinoma). Numerous reports in the medical literature described ocular side effects in patients treated with these drugs. We report on two patients, treated with bisphosphonates due to malignancy, who presented with unilateral and bilateral uveitis. Read More

Clin J Am Soc Nephrol 2017 Jun 26;12(6):965-973. Epub 2017 May 26.

Division of Nephrology, McMaster University, Hamilton, Ontario, Canada.

Background And Objectives: Hyperphosphatemia is common among recipients of maintenance dialysis and is associated with a higher risk of mortality and cardiovascular events. A large randomized trial is needed to determine whether lowering phosphate concentrations with binders improves patient-important outcomes. To inform such an effort we conducted a pilot randomized controlled trial. Read More

Orthop Surg 2017 May 24;9(2):145-151. Epub 2017 May 24.

Department of Trauma and Orthopaedic Surgery, University College Hospital Galway, Saolta Hospital Group, Galway, Ireland.

Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database review including pertinent articles exploring the multidisciplinary management of spinal metastatic disease. Read More

Medicine (Baltimore) 2017 May;96(21):e6968

aThird Department of Internal Medicine, Hokkaido P.W.F.A.C., Obihiro-Kosei General Hospital, Obihiro bDepartment of Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Hokkaido University, Sapporo cDepartment of Diabetes and Endocrinology, Sapporo Medical Center, NTT EC, Sapporo dDivision of Dermatology eDivision of Pathology, Hokkaido P.W.F.A.C., Obihiro-Kosei General Hospital, Obihiro, Japan.

Rationale: Palisaded neutrophilic and granulomatous dermatitis (PNGD) is a benign, inflammatory dermatosis with distinct histopathological features often observed in patients with systemic diseases. There were no reports of PNGD without underlying systemic diseases as an underlying cause of hypercalcemia. Herein, we report a case of a 62-year-old man with hypercalcemia due to PNGD, but with no underlying systemic diseases, including tuberculosis, sarcoidosis, or vasculitis. Read More

Gan To Kagaku Ryoho 2017 May;44(5):405-408

Dept. of Surgical Oncology, Osaka City University Graduate School of Medicine.

We retrospectively investigated the efficacy and safety of S-1 and oxaliplatin(SOX)as the first-line chemotherapy in patients with metastatic/recurrent gastric cancer. A total of 27 patients who received SOX as the first-line chemotherapy in our hospital were considered for the study. The SOX chemotherapy schedule consisted of 1 course every 3 weeks. Read More

J Intensive Care Med 2017 Jan 1:885066617706650. Epub 2017 Jan 1.

3 Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Electrolyte disturbances are frequently encountered in critically ill oncology patients. Hyponatremia and hypernatremia as well as hypocalcemia and hypercalcemia are among the most commonly encountered electrolyte abnormalities. In the intensive care unit, management of critical electrolyte disturbances is focused on initial evaluation and immediate treatment plan to prevent severe complications. Read More

Reumatismo 2017 May 22;69(1):9-15. Epub 2017 May 22.

Department of Medicine, Rheumatology Unit, University of Verona.

Osteonecrosis of the jaw (ONJ) is a rare adverse event of antiresorptive drugs such as bisphosphonates (BP) and denosumab (DMAb). The diagnosis of ONJ is considered in cases where exposed bone in the maxillofacial region does not heal within 8 weeks in a patient previously treated with an antiresorptive agent. In patients with osteoporosis, ONJ is reported as a very rare adverse event while in oncologic patients with bone metastases or malignant hypercalcemia the incidence is significantly higher (up to the 1-10% of the patients). Read More

Indian J Nucl Med 2017 Apr-Jun;32(2):150-152

Department of Radio-Diagnosis, Infocus Diagnostics, Ahmedabad, Gujarat, India.

Hypercalcemia is a common life-threatening complication associated with several malignancies. Parathyroid-related peptide has been shown to cause hypercalcemia in several solid tumors but rarely in penile cancer. We report a case of penile cancer with hypercalcemia causing metastatic visceral calcification in lungs, liver, and stomach detected on bone scan without significant abnormalities on CT scan. Read More

Harefuah 2017 Jan;156(1):27-28

Department of Pediatrics, Saban Children's Medical Center, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.

Introduction: Hypophosphatasia is the inborn error of metabolism that is characterized by low serum alkaline-phosphatase activity, due to loss-of-function mutations within the gene for tissuenonspecific isoenzyme of alkaline phosphatase [TNSALP]. The manifestations of hypophosphatasia range from neonatal death with almost no skeletal mineralization to dental problems in adults without any bone symptoms. There are no case reports of infantile hypophosphatasia in Israel. Read More

Horm Metab Res 2017 May 19. Epub 2017 May 19.

Medical Faculty, Department of General, Visceral and Vascular Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.

The role of parathyroid hormone (PTH) serum levels for prediction of outcome is ill defined for parathyroid cancer, which is a very rare disease. This investigation of 17 consecutive patients with parathyroid cancer, (re-)operated on at a tertiary referral center between 1994 and July 2016, with a mean follow-up of 179.6 months (15 years) aimed to clarify the suitability of PTH serum levels for prediction of clinical outcome after comprehensive operative management of parathyroid cancer. Read More

Medwave 2017 May 12;17(Suppl2):e6942. Epub 2017 May 12.

Proyecto Epistemonikos, Santiago, Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Chronic kidney disease-mineral and bone disorder is prevalent. There is controversy regarding whether calcium-based phosphate binders or sevelamer - a non-calcium phosphate binder – constitute a better therapeutic alternative. Searching in Epistemonikos database, which is maintained by screening multiple information sources, we identified 12 systematic reviews comprising 61 studies of which 41 correspond to randomized trials addressing the question of this article. Read More

Glob Pediatr Health 2017 2;4:2333794X17705955. Epub 2017 May 2.

Children's Mercy Hospital, University of Missouri at Kansas City, MO, USA.

Severe hypercalcemia in infants is usually attributed to genetic etiologies and less commonly to acquired ones. An 8-week-old girl presented with failure to thrive, mild respiratory distress, and life-threatening hypercalcemia (23.5 mg/dL). Read More

Eur J Endocrinol 2017 Jul;177(1):K1-K6

Department of Internal Medicine

Objective: Autoimmune lymphocytic parathyroiditis and acquired hypocalciuric hypercalcemia associated with autoantibodies against the calcium-sensing receptor (anti-CaSR) are rare and poorly understood conditions. Here, we describe a patient with acquired parathyroid hormone (PTH)-dependent hypercalcemia with associated hypocalciuria, found to have true lymphocytic parathyroiditis on histopathology, and circulating anti-CaSR antibodies in serum.

Design And Methods: A 64-year-old woman was referred to our clinic for persistent hypercalcemia after a subtotal parathyroidectomy. Read More

Case Rep Oncol 2017 Jan-Apr;10(1):272-275. Epub 2017 Mar 29.

bHurley Medical Center, Flint, MI, USA.

Immunoglobulin D multiple myeloma is a rare type of multiple myeloma that usually presents as bone pain, fatigue, or weight loss. We report a case of immunoglobulin D multiple myeloma in a 53-year-old Caucasian male patient with previous medical history of anaplastic oligodendroglioma status post-surgical resection who was evaluated for back pain while mowing the lawn. His physical examination showed tenderness over the lower thoracic vertebrae with no sensory or motor impairment. Read More

CEN Case Rep 2017 May 27;6(1):111-114. Epub 2017 Feb 27.

Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki-shi, Kanagawa, 216-8511, Japan.

The efficacy and safety of denosumab for the treatment of immobilization-related hypercalcemia in end-stage renal disease remain uncertain. We describe the case of a hemodialysis patient with immobilization-related hypercalcemia who was successfully treated with denosumab. A 79-year-old man admitted for hemodialysis after sustaining an acute kidney injury developed immobilization-related hypercalcemia due to the impairment resulting from an acute myocardial infarction, acute heart failure, and catheter-related bloodstream infection. Read More

CEN Case Rep 2016 Nov 11;5(2):232-237. Epub 2016 Aug 11.

Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.

Myeloma cast nephropathy is a major complication of multiple myeloma. Recent evidence has demonstrated that the earlier induction of bortezomib-based chemotherapy with plasma exchange (PE) provides better results for kidney function and patient survival. Due to its non-selectivity, PE with albumin replacement carries the risk of fibrinogen loss, leading to bleeding. Read More

CEN Case Rep 2016 Nov 22;5(2):141-143. Epub 2016 Jan 22.

Pediatric Nephrology Department, Robert Debré Hospital, 48 Boulevard Sérurier, 75019, Paris, France.

Secondary hyperparathyroidism is often associated with end stage renal disease; even after renal transplantation, hyperparathyroidism may persist, and is responsible for hypercalcemia, hypophosphatemia and elevated parathyroid hormone (iPTH) levels. Parathyroid hyperplasia is frequently associated with persistent hyperparathyroidism, and may require a surgical treatment. Here, we report hyperparathyroidism along with parathyroid hyperplasia in a 7-year-old child, which persisted after renal transplant. Read More

Basic Clin Pharmacol Toxicol 2017 May 15. Epub 2017 May 15.

Department of Pharmacy, Franciscus Gasthuis Hospital, Rotterdam, The Netherlands.

The morbidity and mortality of a severe calcium channel blocker intoxication is high due to serious toxic cardiac effects. Its treatment is supported by low-quality evidence from the heterogeneous literature. We describe a case of a severe diltiazem intoxication and critically appraise the efficacy and role of high-dose calcium and glucagon infusions. Read More

Am J Med Sci 2017 May 29;353(5):492-494. Epub 2016 Apr 29.

Division of Nephrology and Hypertension, Eastern Virginia Medical School, Norfolk, Virginia. Electronic address:

Cosmetic filler injections are known to cause a number of acute and chronic effects, including local inflammation, nodule formation and granulomatous reaction. The timeline of these events is highly variable, occurring from hours to decades following injection. In few cases, systemic effects have been observed. Read More

BMJ Case Rep 2017 May 12;2017. Epub 2017 May 12.

Internal Medicine, MIOT International, Chennai, India.

A 53-year-old woman from Southern India presented with weight loss, anorexia, fever and asthenia. Whole body positron emission tomography/computed tomography (PET-CT) showed fluorodeoxyglucose-avid mediastinal and abdominal lymphadenopathy with hepatic, splenic, parotid and lacrimal glandular inflammations. Endoscopic ultrasound-guided fine needle aspiration of subcarinal lymph node showed non-caseating granulomas. Read More