Hypercalcaemia

Question 1

What are the two main causes of hypercalcaemia?

Answer 1

1. Primary hyperparathyroidism:
2. Malignancy
   > ectopic PTH (squamous cell lung ca)
   > bony mets
   > myeloma

Question 2

Other conditions causing hypercalcaemia

Answer 2

sarcoidosis
vitamin D intoxication
acromegaly
thyrotoxicosis
dehydration
Addison’s disease
Paget’s disease of the bone
Milk-alkali syndrome

Question 3

What drugs can cause hypercalcaemia?

Answer 3

• thiazides
• calcium-containing antacids
• calcium supplements (accrete/adcal)

Question 4

How is hypercalcaemia managed?

Answer 4

• IV 0.9% NaCl 3-4 litres/day
• Following rehydration bisphosphonates may be used.