Hypercalcemia

Question 1

Definition of Hypercalcemia

Answer 1

Hypercalcemia refers to a condition where the concentration of calcium in the blood exceeds the normal range, which is typically between 8.5 and 10.2 milligrams per deciliter (mg/dL) or 2.12 to 2.55 millimoles per liter (mmol/L).

Question 2

Diagnosis of Hypercalcemia

Answer 2

To diagnose hypercalcemia, healthcare providers typically perform a series of tests, including:

Blood tests: A blood sample is taken to measure the levels of calcium, albumin (a protein that binds to calcium), and other relevant markers such as parathyroid hormone (PTH), vitamin D, and kidney function tests.
Urine tests: Urine is collected to measure calcium excretion and check for the presence of other substances such as parathyroid hormone-related peptide (PTHrP), which may indicate the underlying cause.
Imaging: X-rays, bone scans, or other imaging studies may be conducted to assess bone density and detect any abnormalities.

Question 3

Pathomecanism of Hypercalcemia

Question 4

Symptoms of Hypercalcemia

Answer 4

The symptoms of hypercalcemia can vary depending on the severity and rate of increase in calcium levels. Some common symptoms include:

Excessive thirst and frequent urination
Constipation or abdominal pain
Nausea, vomiting, or loss of appetite
Fatigue, weakness, or muscle pain
Confusion, irritability, or difficulty concentrating
Bone pain or fractures
Kidney stones
Irregular heartbeat or palpitations

Question 5

Complications of Hypercalcemia

Answer 5

If left untreated, hypercalcemia can lead to several complications, including:

Kidney damage: High calcium levels can cause the formation of kidney stones or impair kidney function.
Osteoporosis: Prolonged hypercalcemia can lead to weakened bones and increased risk of fractures.
Heart problems: Excessive calcium levels can disrupt the normal electrical signaling in the heart, leading to arrhythmias or other cardiac issues.
Neurological issues: Severe hypercalcemia may affect the central nervous system, causing confusion, coma, or even seizures.

Question 6

Hypercalcemia and associated diseases

Answer 6

Hypercalcemia can be associated with various underlying conditions, including:

Primary hyperparathyroidism: Overactivity of the parathyroid glands, usually due to a benign tumor, leading to excessive production of parathyroid hormone (PTH).

Malignancy: Some cancers, such as those affecting the lung, breast, kidney, or multiple myeloma, can cause hypercalcemia by releasing substances that affect calcium metabolism.

Vitamin D disorders: Abnormalities in vitamin D metabolism or excess intake can result in elevated calcium levels.

Hyperthyroidism: Overactive thyroid function can indirectly contribute to hypercalcemia.
Medications: Certain medications like thiazide diuretics, lithium, or excessive calcium supplementation can cause hypercalcemia.

Question 7

Treatment of Hypercalcemia

Answer 7

Intravenous fluids: Hydration with saline solution can help increase urine output and promote calcium excretion.
Medications: Bisphosphonates, calcitonin, and corticosteroids may be prescribed to inhibit bone resorption, reduce calcium absorption, or decrease the production of substances that raise calcium levels.
Treatment of underlying conditions