Elevated Serum Calcium
Excess parathyroid hormone (PTH) secretion from a single parathyroid adenoma, hyperplasia of the parathyroids, parathyroid carcinoma
Especially tumors of the breast, lung, and kidney in which hypercalcemia may occur from direct bony metastasis
Multiple myeloma that directly degrades bone
Other cancers that produce hypercalcemia by inducing PTH secretion
Excess vitamin D intake
Prolonged use of diuretics and thiazides known to produce hypercalcemia
Severe hypercalcemia favors a diagnosis of cancer.
Commonly Encountered Situations
Hypercalcemia from malignancy is especially common.
Suggested Additional Lab Testing
In primary hyperparathyroidism, serum PTH is increased and serum phosphorus is decreased.
In hypercalcemia of malignancy, serum phosphorus is decreased in approximately 50% of patients, and there is a decrease in the serum PTH in these patients.
Serum protein electrophoresis is useful in the assessment for multiple myeloma. Serum 1,25-dihydroxy vitamin D is low in hypercalcemia of malignancy. It is often increased in primary hyperparathyroidism.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
Clinical Pain Advisor Articles
- History of Migraine May Be Associated With Higher Risk for Cochlear Disorders
- Radiofrequency Denervation Efficacious in Treating Thoracic Zygapophyseal Joint Pain
- Symptom Severity, Sensory Sensitivity May Indicate Pain Centralization in Chronic Overlapping Pain Conditions
- Prescribed Opioids Difficulties Scale Effective for Assessing Concerns of Patients With Chronic Pain
- Predictors of Opioid Overdose in High-Risk Users
- Consensus Guidelines for the Use of Intravenous Ketamine for Chronic Pain
- Pain Societies Issue Guidelines on Use of Ketamine for the Management of Acute Pain
- Labor Epidural Analgesia Linked to Reduced Likelihood of Successful Breastfeeding
- Novel Oral Treatment Safe, Effective for Migraine Headache Relief
- DFN-02 Nasal Spray Safe, Effective for Acute Treatment of Episodic Migraine
- Higher PainDETECT Scores, Neuropathic Pain Preoperatively May Increase Risk for Chronic Pain Post-TKR
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Erenumab Reduces Monthly Migraine Days in Patients With Treatment-Resistant Migraine
- Government and Industry Lead the Way in Funding USPSTF Systematic Reviews
- Communication-Based Intervention Increases Goals-of-Care Discussions Between Physicians, Patients With Serious Illness