Hypercalcemia

Basics

Description

  • Severity depends on serum calcium level and rate of increase
  • Affects 1% of population worldwide and 2% of patients with cancer
  • Most cases mild (<12 mg/dL) and asymptomatic
  • Hypercalcemic crisis usually >14 mg/dL, or ionized calcium of >10 mg/dL causes serious signs and symptoms
  • Calcium in bloodstream in 3 forms:
    • Ionized: 50%
    • Bound to protein (primarily albumin): 40%
    • Bound to other anions: 10%
  • Ionized calcium – only physiologically active form

Etiology

  • Primary hyperparathyroidism
  • Malignancy
  • Above causes account for 90% of cases
  • Miscellaneous causes: Sarcoidosis, thyroid disease, immobilization, infection, medications, supplements

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