Updated: 10/10/2016

Hypercalcemia

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Introduction
  • Causes of hypercalcemia include
    • malignancy
      hypercalcemia in malignancy caused by parathyroid-related hormone protein (PTHrP)
    • characterized by:
      • hypercalcemia, hypophosphatemia, low PTH
      • examples of malignancies:
        •  Paget's Disease
        •  Multiple Myeloma
        • Squamous cell cancer of the lung
          • ectopic production of PTH
        • Multiple endocrine neoplasia (type I and II)
        • Pituitary adenoma

    • medical conditions
      • primary hyperparathyroidism
      • sarcoidosis
      • Familial hypocalciuric hypercalcemia
      • hyperthyroidism
      • Addison's disease
      • Zollinger-Ellison syndrome
    • drugs
      • thiazide diuretics
    • dietary
      • calcium ingestion (milk-alkali syndrome)
      • hypervitaminosis D
      • hypervitaminosis A
Presentation
  • Symptoms
    • CNS
      • confusion
      • stupor
      • weakness
    • gastrointestinal
      • constipation
      • anorexia
      • nausea
      • vomiting
    • kidney
      • polyuria
      • kidney stones
      • polydipsia

Treatment
  • Hydration
    • saline diuresis
  • Drug therapies
    • loop diuretics
    • bisphosphonates
    • mithramycin
    • calcitonin
    • galium nitrate
  • Dialysis (severe)
 

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