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Hypercalcemia

Hypercalcaemia (or Hypercalcemia) is an elevated calcium level in the blood. It can be an asymptomatic laboratory finding, but because an elevated calcium level is often a clue to other serious disease, a diagnosis should be undertaken if it persists. more...

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Signs and symptoms

Hypercalcemia per se can result in fatigue, depression, confusion, anorexia, nausea, vomiting, constipation, or increased urination; if it is chronic it can result in urinary calculi (renal stones or bladder stones). Abnormal heart rhythms can result, and an EKG finding of a short QT interval suggests hypercalcemia.

Symptoms are more common at high calcium levels (12.0 mg/dL or 3 mmol/l). Severe hypercalcemia (above 15-16 mg/dL or 3.75-4 mmol/l) is considered a medical emergency: at these levels, coma and cardiac arrest can result.

Causes

  • abnormal parathyroid gland function
    • primary hyperparathyroidism
      • solitary parathyroid adenoma
      • primary parathyroid hyperplasia
      • parathyroid carcinoma (C750)
      • multiple endocrine neoplasia (MEN)
      • familial isolated hyperparathyroidism (OMIM 146200)
    • lithium use
    • familial hypocalciuric hypercalcemia/familial benign hypercalcaemia (OMIM 145980, OMIM 145981, OMIM 600740)
  • malignancy
    • solid tumor with metastasis (e.g. breast cancer)
    • solid tumor with humoral mediation of hypercalcemia (e.g. lung or kidney cancer)
    • hematologic malignancy (multiple myeloma, lymphoma, leukemia)
  • vitamin-D metabolic disorders
    • hypervitaminosis D (vitamin D intoxication)
    • elevated 1,25(OH)2D levels (e.g. sarcoidosis and other granulomatous diseases)
    • idiopathic hypercalcemia of infancy (OMIM 143880)
    • rebound hypercalcemia after rhabdomyolysis
  • disorders related to high bone-turnover rates
    • hyperthyroidism
    • prolonged immobilization
    • thiazide use
    • vitamin A intoxication
  • renal failure
    • severe secondary hyperparathyroidism
    • aluminum intoxication
    • milk-alkali syndrome

Treatments

Definitive treatment is directed at the underlying cause. Emergency treatment consists of intravenous hydration, increased salt intake, use of diuretics, and in extreme cases such drugs as bisphosphonates or calcitonin.

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Calcium Homeostasis : Hypercalcemia and Hypocalcemia $42.00 Gale Encyclopedia of Cancer : Hypercalcemia $4.70
Parathyroid Hormone - Related Protein: Normal Physiology and Its Role in Cancer $75.00 Hypercalcemia of Malignancy: Etiology, Pathogenesis, and Clinical Management (Medical Intelligence Unit) $28.40
Acid-base and electrolyte disturbances in patients with hypercalcemia. : An article from: Southern Medical Journal $5.95 MED-18. Paget's disease in the differential diagnosis of hypercalcemia.(Section on Internal Medicine) : An article from: Southern Medical Journal $5.95
Molecular & Clinical Genetic Studies of a Novel Variant of Familial Hypercalcemia (Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1147) $17.50 Gale Encyclopedia of Alternative Medicine : Hyperparathyroidism $3.90
Hypercalcemia of malignancy (Recent results in cancer research) $19.99 Two Causes of Hypercalcemia: Learning by the Holmesian Method : An article from: Mayo Clinic Proceedings $20.00

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