hypercalcemia

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Introduction

Elevation of serum/plasma Ca+2, clinically significant when ionized Ca+2 is increased. Albumin binds 45% of serum Ca+2, thus a normal calcium in the face of hypoalbuminemia may result in clinically significant hypercalcemia.

Etiology

Epidemiology

Pathology

Clinical manifestations

* Mnemonic: bones, stones, groans, thrones, psychiatric overtones

Laboratory

* simultaneous measurement of serum calcium & serum PTH facilitates classification as PTH-related or non-PTH-related hypercalcemia, thus serum PTH takes priority over serum ionized Ca+2[3][11]

Diagnostic procedures

Management

(also see hypercalcemia of malignancy)

More general terms

More specific terms

Additional terms

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 830
  2. Jump up to: 2.0 2.1 Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 490
  3. Jump up to: 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2012, 2015, 2018, 2022.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  4. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 680-681
  5. Jump up to: 5.0 5.1 ARUP Consult: Hypercalcemia The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/hypercalcemia
    Hypercalcemia Testing Algorithm https://arupconsult.com/algorithm/hypercalcemia-testing-algorithm
  6. Jump up to: 6.0 6.1 6.2 6.3 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  7. Jump up to: 7.0 7.1 Gallagher JC et al Incidence of hypercalciuria and hypercalcemia during vitamin D and calcium supplementation in older women. Menopause. June 16m 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24937025 <Internet> http://journals.lww.com/menopausejournal/Abstract/publishahead/Incidence_of_hypercalciuria_and_hypercalcemia.98368.aspx
  8. Donovan PJ, Sundac L, Pretorius CJ et al Calcitriol-mediated hypercalcemia: causes and course in 101 patients. J Clin Endocrinol Metab. 2013 Oct;98(10):4023-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23979953
  9. Jump up to: 9.0 9.1 NEJM Knowledge+ Question of the Week. Dec 29, 2020 https://knowledgeplus.nejm.org/question-of-week/1660/
    Goldner W. Cancer-related hypercalcemia. J Oncol Pract 2016 May; 12:426. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27170690
    Zagzag J et al. Hypercalcemia and cancer: differential diagnosis and treatment. CA Cancer J Clin 2018 Sep; 68:377. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30240520 DOI: Free article
  10. NEJM Knowledge+ Nephrology/Urology
  11. Jump up to: 11.0 11.1 11.2 Insogna KL. Primary hyperparathyroidism. N Engl J Med. 2018;379:1050-1059. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30207907
  12. Hypercalcemia (PDQ) http://www.cancer.gov/cancertopics/pdq/supportivecare/hypercalcemia/HealthProfessional

Patient information

hypercalcemia patient information