Corrected calcium versus ionized calcium measurements for identifying hypercalcemia in patients with multiple myeloma

Buege, Michael J; Do, Bryan; Lee, Hans C.; Weber, Donna M.; Horowitz, Sandra B.; Liu, Feng; Qing, Yun; Shank, Brandon R.

doi:10.1016/j.ctarc.2019.100159

Cited by 14 publications

(6 citation statements)

References 29 publications

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“…Therefore, it was suggested, that CaI should not be measured routinely in these patients [16]. Yet, in cases of multiple myeloma, which affects the bones, we think that CaI should be preferred [17]. However, as shown in this study CaT is sufficient for identifying HC in many clinical situations, and because CaT is much easier to produce in the lab compared to CaI, CaT should be chosen when possible and relevant.…”

Section: When To Use Caimentioning

confidence: 87%

“…CaI should be considered in a number of clinical situations such as calcium metabolic diseases [8,14], CKD [15], low albumin, and cancer [16] including multiple myeloma [17]. CaI has been shown to be a more sensitive indicator of PHPT in cases of calcium metabolic disease and more linearly associated with adenoma size in a study with 269 patients who had all undergone PTX because of PHPT [14].…”

Section: When To Use Caimentioning

confidence: 99%

See 1 more Smart Citation

Total Calcium and Ionized Calcium (pH = 7.4) Tests Are Equal When Screening Patients for Hypercalcemia at Admission in the Emergency Department: A Retrospective Descriptive Study

et al. 2021

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Section: When To Use Caimentioning

confidence: 87%

Section: When To Use Caimentioning

confidence: 99%

Total Calcium and Ionized Calcium (pH = 7.4) Tests Are Equal When Screening Patients for Hypercalcemia at Admission in the Emergency Department: A Retrospective Descriptive Study

et al. 2021

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“…The concentration of serum calcium may be analyzed as total calcium, albumin-corrected calcium, or ionized calcium. The measurement of ionized calcium seems to be the best form because it represents the physiologically active proportion of calcium in the serum, but the method of its measurement is difficult and for that reason it is not routinely used, even in research studies [ 61 ]. In this study, we analyzed total calcium and albumin-corrected calcium.…”

Section: Discussionmentioning

confidence: 99%

The Association between Branched-Chain Amino Acids (BCAAs) and Cardiometabolic Risk Factors in Middle-Aged Caucasian Women Stratified According to Glycemic Status

et al. 2021

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We examined the glycemic status-stratified relationships between total serum branched-chain amino acid (BCAA) concentrations and cardiometabolic risk factors in middle-aged Caucasian women. The study included 349 women divided into 2 subgroups: a normoglycemic group (NG, n = 184) and a dysglycemic group (DG, n = 165). Blood samples, anthropometric parameters, and blood pressure were measured. HOMA-IR, albumin-corrected calcium (CCa), and fatty liver index (FLI) were calculated. BCAA concentrations were higher in the women with dysglycemia. BCAAs moderately correlated with BMI and FLI in the NG group and with BMI, FLI, total calcium (TCa), CCa, HbA1c, TG/HDL-C, and HDL-C in the DG group. After adjusting for age and BMI, correlations for TCa, CCa, HbA1c, HDL-C, and TG/HDL-C remained significant. The coexistence of increased BCAAs with dysglycemic status was associated with markedly higher concentrations of TCa, CCa, HbA1c, and TG, which were not observed in the DG women with low level of BCAAs. Multiple regression showed that TCa or CCa, age and BCAAs were significantly associated with HbA1c independently of BMI only in the DG group. We conclude that dysglycemia in particular predisposes women to a significant relationship between total BCAAs and circulating calcium and HbA1c, and that these relationships are independent of BMI and may reflect the pathophysiological calcium-dependent mechanisms connecting BCAAs with metabolic disturbances.

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“…Lytic lesions and bone pain are results of infiltration of plasmocytes in the bone marrow, which causes an imbalance in the interaction between osteoclast and osteoblast and the plasmocytes adherence to the stroma, causing production of osteoclast, activating factors, suppression of osteogenesis and activation bone destruction. 26 Lytic bone lesions are an important feature of multiple myeloma, in particular, because they cause pain and hypercalcemia, and lead to bone complications. 27 Elevated calcium levels, usually seen in patients with advanced MM, are associated with symptoms such as fatigue, confusion, weakness, vomiting, excessive urination, renal and neurological disorders, lethargy and coma.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors in multiple myeloma and the impact of the bone involvement

Oliveira¹,

Souza²,

Bueno³

et al. 2021

Int J Sci Rep

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Background: Multiple myeloma is characterized by abnormal plasmocytes proliferation in the bone marrow, resulting in an immunoglobulin oversecretion, which can cause bone pain, anemia, kidney dysfunction, and infections. The present study evaluates prognostic factors and the bone involvement in patients who had a confirmed diagnosis of MM.Methods: A retrospective study was conducted in hospital universitário São Francisco of Bragança Paulista. Patient demographic data, laboratory parameters and treatment received were recorded. We also analyzed the variables related to diagnosis and the development of bone lesions in MM patients.Results: A total of 42 patients had a confirmed diagnosis of MM, out of which most (54.76%) were older than 65. Most patients (45.24%) had beta-2-microglobulin values greater than 5.5 mcg/dl, indicating an advanced stage of the disease and consequently a less favorable prognosis. The main clinical manifestation observed was anemia in 61.90% (26/42) and bone lesions 59.52% (25/42). The analysis of imaging exams showed that most patients presented bone alterations, such as osteopenia, lytic lesions and fractures. Interestingly, 11.90% patients were submitted to autologous bone marrow transplantation with further remission of the disease. Bone marrow transplantation increases overall survival and disease-free survival when compared to conventional treatment.Conclusions: Since MM prognostic factors are numerous and, therefore, the understanding and analysis of the clinical and laboratory features of MM can contribute to an early diagnosis of patients, a targeted therapeutic approach and better outcomes.

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Corrected calcium versus ionized calcium measurements for identifying hypercalcemia in patients with multiple myeloma

Cited by 14 publications

References 29 publications

Total Calcium and Ionized Calcium (pH = 7.4) Tests Are Equal When Screening Patients for Hypercalcemia at Admission in the Emergency Department: A Retrospective Descriptive Study

Total Calcium and Ionized Calcium (pH = 7.4) Tests Are Equal When Screening Patients for Hypercalcemia at Admission in the Emergency Department: A Retrospective Descriptive Study

The Association between Branched-Chain Amino Acids (BCAAs) and Cardiometabolic Risk Factors in Middle-Aged Caucasian Women Stratified According to Glycemic Status

Prognostic factors in multiple myeloma and the impact of the bone involvement

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