Not uncommon. He will have Vitamin D deficiency.
Ca Prostate is also a common scenario where this
happens more commonly (osteoblastic mets). Suggest
they give him a decent amount of Vitamin D (usual
oral supplements are homeopathic) such as imi
calciferol 300,000 Units IMI, as well as oral
supplements (high dose oral D if locally
obtainable). Check his plasma 25(OH)D before
administering for the record.
Sounds as if he should be in hospital for some iv
magnesium/Ca/K until he gets over his immediate
problems.
Aubrey
--
/\=========================================
|| Dr Aubrey Blumsohn
|| Senior Lecturer in Metabolic Bone Disease
|| Bone Metabolism Laboratory
|| Human Nutrition Unit
|| Division of Clinical Sciences (NGHT)
|| Clinical Sciences Centre
|| Northern General Hospital, Herries Road
|| Sheffield S5 7AU, England
|| Email: [log in to unmask]
|| Tel: 114-2715963(office)
|| Fax: 0114 261 8775 (fax)
\/=========================================
GM> A patient with Ca Prostate was given
GM> monthly infusions of Bisphosphonates
GM> not for Hypercalcaemia, but to reduce his bone pain.
GM> On commencing his Calcium was 2.36, Alk.
GM> Phos 133, Potassium 3.4 and
GM> Creatinine 146.
GM> He went for 5 months without further
GM> calcium measurements, but when they
GM> were done his Calcium was 1.65, Alk. Phos
GM> 267, Potassium 2.9 and Creatinine
GM> 211.
GM> GP was going to discuss with oncologist
GM> and put patient on oral Calcium,
GM> Magnesium and Vitamin D following the
GM> following set of results, Calcium
GM> 1.49, Alk. Phos 304, Potassium 3.1,
GM> Creatinine 201, Magnesium 0.45. Patient
GM> now complaining of cramps and muscle
GM> weakness, and can't walk down the
GM> corridor to GP's consulting room.
GM> Most recent results similar, Calcium
GM> 1.67, Alk. Phos 294, Potassium 3.3,
GM> Creatinine 132, Magnesium 0.46.
GM> BNF suggests check for hypocalcaemia
GM> before start treatment, but can't find
GM> anything about how long it will take to
GM> rectify this medically induced set
GM> of abnormal Biochemistry results. I don't
GM> think it will be a quick fix
GM> cure, especially if they continue with
GM> the monthly infusions.
GM> Has anyone else seen this before, if so
GM> any advice on timescales would be
GM> welcome.
GM> Regards,
GM> Gary
GM> G.C. Mascall
GM> Clinical Biochemistry Department
GM> Kidderminster & Redditch
GM> Worcestershire
GM> ------ACB discussion List Information--------
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Regards
Aubrey Blumsohn
------ACB discussion List Information--------
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community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
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