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Hypercalcemia (hypercalcaemia)

Why doesn't the use of olmesartan lead to hypercalcemia?

Since calcitriol (the active form of vitamin D) is a Vitamin D receptorA nuclear receptor located throughout the body that plays a key role in the innate immune response. (VDRThe Vitamin D Receptor. A nuclear receptor located throughout the body that plays a key role in the innate immune response.) agonist, and use of this substance can cause hypercalcemia, one may expect that olmesartanMedication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor. Also known by the trade name Benicar. , through effects on the VDR, may also cause hypercalcemia if the dosage is high. There is however no evidence that this is an effect of olmesartan, and the reason for the differing effects appears to reside in the non-VDR effects of calcitriol. 1)

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Notes and comments

<DiseaseHierarchy>

This paper explains the out of range values for kidney and liver functions, which suggest that I may be a little premature in stopping the MP.

But it doesn't explain the elevated calcium results (which is at 3.00 mmol/L). This result has my GP really concerned as it could indicate malignancy.

Any comments?

Cheers Guss

Am J Med Sci. 1995 Aug;310(2):71-6.Case report: vitamin D-mediated hypercalcemia in fungal infections. Spindel SJ, Hamill RJ, Georghiou PR, Lacke CE, Green LK, Mallette LE. Source Section of Infectious Disease, Veterans Affairs Medical Center, Houston, TX 77030, USA. Abstract Hypercalcemia has been well described in a variety of neoplastic and granulomatous diseases. One mechanism for this hypercalcemia is via the excess production of 1,25-dihydroxyvitamin DPrimary biologically active vitamin D hormone. Activates the vitamin D nuclear receptor. Produced by hydroxylation of 25-D. Also known as 1,25-dihydroxycholecalciferol, 1,25-hydroxyvitamin D and calcitirol. from extra-renal sources. The authors describe an AIDS patient infected with Cryptococcus neoformans who had suggestive evidence of vitamin D-mediated hypercalcemia. He had an elevated serum 1,25-dihydroxyvitamin D value, a normal 25-hydroxyvitamin D value, and low values for parathyroid hormone and parathyroid hormone-related peptide. Most previously reported cases of hypercalcemia associated with fungal infections did not include sufficient evidence to implicate a role for excess 1,25-dihydroxyvitamin D production, except for two case reports involving patients with hypercalcemia with infections due to Pneumocystis carinii and Candida albicans. The authors' patient's hypercalcemia resolved during treatment of his underlying infection. Patients with hypercalcemia or in whom hypercalcemia develops during a disseminated fungal infection should have vitamin D metabolites measured as part of their work-up.

PMID: 7631647

References

1)
Improvement of impaired calcium and skeletal homeostasis in vitamin D receptor knockout mice by a high dose of calcitriol and maxacalcitol.
Shiizaki K, Hatamura I, Imazeki I, Moriguchi Y, Sakaguchi T, Saji F, Nakazawa E, Kato S, Akizawa T, Kusano E
Bone45p964-71(2009 Nov)
home/diseases/hypercalcemia.txt · Last modified: 10.17.2018 by sallieq
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