Transcription of Oncologic emergency ー高カルシウム血症ー
1 Oncologic emergency Oncologic emergency etc Oncologic emergency etc Ca Alb Ca Alb < Alb Payne Ca /dL = Ca Alb Ca /dL Ca 12 /dL 12 Ca 14 14 /dL Ca etc 2 9 FHH 3 VitD VitD3 VitD3 Immobilization etc Ca Ca D 3 HHM LOH etc FeCa FeCa 1 Intact PTH Intact PTH PTHrP PTHrP 1,25(OH)2 -VitD3 Calcitriol PTH * Whole PTH intact PTH PTH Intact PTH Whole PTH PTH PTH-C PTH PTH 7-84 PTH PTH PTH PTH C PTH PTH / Ca PTH etc 2 9 3 VitD VitD3 VitD3 etc 10 30 HHM humoral hypercalcemia of malignancy LOH local osteolytic hypercalcemia VitD3 PTH HHM humoral hypercalcemia of malignancy 80% PTHrP ATL PTH P
2 Ca LOH local osteolytic hypercalcemia 20% PTHrP RANK/RANKL IL-6 IL-8 IL-1 VEGF IL-6 RANKL MIP 1a OPG IL-3 Ca LOH RANK/RANKL RANK- Ligand RANK PTH IL-6 MIP-1 1 25 OH 2D3 Ca Ca Ca VitD3 PTH PSL 20 50mg/ PTH 2-3L/ 300ml/hr 40 2 / Ca 4 15 48 72 GFR 120 RANKL LOH RANK/RANKL RANK- Ligand RANK PTH IL-6 MIP-1 1 25 OH 2D3 Ca Ca Ca LOH RANK- Ligand RANK PTH IL-6 MIP-1 1 25 OH 2D3 Ca Ca Ca LOH
3 RANK- Ligand RANK PTH IL-6 MIP-1 1 25 OH 2D3
