| Hypercalcemia | |
|---|---|
| Other names | Hypercalcaemia |
 | |
| Calcium within the periodic table | |
| Specialty | Endocrinology |
| Symptoms | Abdominal pain, bone pain, confusion, depression, weakness[1][2] |
| Complications | Kidney stones, abnormal heart rhythm, cardiac arrest[1][2] |
| Causes | Primary hyperparathyroidism, cancer, sarcoidosis, tuberculosis, Paget disease, multiple endocrine neoplasia, vitamin D toxicity[1][3] |
| Diagnostic method | Blood serum level > 2.6 mmol/L (corrected calcium or ionized calcium)[1][2] |
| Treatment | Underlying cause, intravenous fluids, furosemide, calcitonin, pamidronate, hemodialysis[1][2] |
| Medication | See article |
| Frequency | 4 per 1,000[1] |
Hypercalcemia, also spelled hypercalcaemia, is a high calcium (Ca2+) level in the blood serum.[1][3] The normal range is 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), with levels greater than 2.6 mmol/L defined as hypercalcemia.[1][2][4] Those with a mild increase that has developed slowly typically have no symptoms.[1] In those with greater levels or rapid onset, symptoms may include abdominal pain, bone pain, confusion, depression, weakness, kidney stones or an abnormal heart rhythm including cardiac arrest.[1][2]
Most outpatient cases are due to primary hyperparathyroidism and inpatient cases due to cancer.[1] Other causes of hypercalcemia include sarcoidosis, tuberculosis, Paget disease, multiple endocrine neoplasia (MEN), vitamin D toxicity, familial hypocalciuric hypercalcaemia and certain medications such as lithium and hydrochlorothiazide.[1][2][3] Diagnosis should generally include either a corrected calcium or ionized calcium level and be confirmed after a week.[1] Specific changes, such as a shortened QT interval and prolonged PR interval, may be seen on an electrocardiogram (ECG).[2]
Treatment may include intravenous fluids, furosemide, calcitonin, intravenous bisphosphonate, in addition to treating the underlying cause.[1][2] The evidence for furosemide use, however, is poor.[1] In those with very high levels, hospitalization may be required.[1] Haemodialysis may be used in those who do not respond to other treatments.[1] In those with vitamin D toxicity, steroids may be useful.[1] Hypercalcemia is relatively common.[1] Primary hyperparathyroidism occurs in 1–7 per 1,000 people, and hypercalcaemia occurs in about 2.7% of those with cancer.[1]
- ^ a b c d e f g h i j k l m n o p q r s t Minisola S, Pepe J, Piemonte S, Cipriani C (2015). "The diagnosis and management of hypercalcaemia". BMJ. 350: h2723. doi:10.1136/bmj.h2723. PMID 26037642. S2CID 28462200.
- ^ a b c d e f g h i Soar J, Perkins GD, Abbas G, Alfonzo A, Barelli A, Bierens JJ, Brugger H, Deakin CD, Dunning J, Georgiou M, Handley AJ, Lockey DJ, Paal P, Sandroni C, Thies KC, Zideman DA, Nolan JP (2010). "European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution". Resuscitation. 81 (10): 1400–33. doi:10.1016/j.resuscitation.2010.08.015. PMID 20956045.
- ^ a b c "Hypercalcemia - National Library of Medicine". PubMed Health. Archived from the original on 8 September 2017. Retrieved 27 September 2016.
- ^ "Appendix 1: Conversion of SI Units to Standard Units". Principles and Practice of Geriatric Medicine. Vol. 2. 2005. i–ii. doi:10.1002/047009057X.app01. ISBN 978-0-470-09057-2.