This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the author's clinicalrecommendations.
A 47-year-old woman with a history of breast cancer presentswith confusion and dehydration. The serum calcium level is 18.0mg per deciliter (4.5 mmol per liter). She has postural hypotensionand low central venous pressure on examination of the jugularveins. The serum phosphorus level is 5.0 mg per deciliter (1.6mmol per liter), the blood urea nitrogen level is 80.0 . . . [Full Text of this Article]
The Clinical Problem
Strategies and Evidence
Diagnosis
Therapeutic Considerations
General Supportive Measures
Saline Hydration and Calciuresis
Medications
Other Pharmacologic Agents
Dialysis
Areas of Uncertainty
Guidelines
Recommendations
Source Information
From the Division of Endocrinology, University of Pittsburgh School of Medicine, Pittsburgh.
Address reprint requests to Dr. Stewart at the Division of Endocrinology and Metabolism, BST E-1140, University of Pittsburgh School of Medicine, 200 Lothrop St., Pittsburgh, PA 15213, or at stewart@dom.pitt.edu.
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