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Inorganic Phosphate Treatment of Hypercalcemia of Diverse Etiologies

List of authors.
  • Ralph S. Goldsmith, M.D.,
  • and Sidney H. Ingbar, M.D.

HYPERCALCEMIA occurs in a wide variety of diseases (for example, hyperparathyroidism, hypervitaminosis D, sarcoid, cancer, hyperthyroidism and poliomyelitis)1 and is often responsible for many of the symptoms associated with them. Most often, these symptoms are more distressing than disabling and include such nonspecific complaints as constipation, dyspepsia, lassitude, easy fatigability and polyuria. Underlying these mild symptoms, however, is a process that may lead to nephrolithiasis and nephrocalcinosis. Of even more serious import2 is the usually fatal syndrome that has been called hypercalcemic crisis — intractable nausea and vomiting, dehydration, stupor, coma and azotemia. Since this constitutes a true medical emergency . . .

Funding and Disclosures

* From the Thorndike Memorial Laboratory, Second and Fourth (Harvard) Medical Services, Boston City Hospital, and the Department of Medicine, Harvard Medical School.

Supported in part by a grant (CA01756–03) from the National Cancer Institute and a grant (843–317) from the Clinical Research Center, National Institutes of Health, Bethesda, Maryland.

§ Some patients were treated under the supervision of Drs. Lewis E. Braverman, Norman G. Levinsky, Albert Schilling, Richard Shadduck and Sidney Salmon, whose co-operation and assistance are gratefully acknowledged.

We are indebted to Miss Margaret J. Finnegan and Miss Ann Baranauskas for valuable technical assistance and to Miss Loretta Eldridge for preparing the intravenous solutions.

Author Affiliations

BOSTON

† Associate in medicine, Harvard Medical School; assisting physician, Second and Fourth (Harvard) Medical Services, Boston City Hospital.

‡ Associate professor of medicine, Harvard Medical School; physician-in-charge, Endocrine Out-Patient Department, Boston City Hospital.

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