Here you will find basic and more advanced resources about hypercalcaemia. If you want to test your knowledge first, take the quiz.
The basics |
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In hospitalised patients hypercalcaemia is most often caused by malignancy. It occurs in 20-30% of patients with cancer. Most commonly this is due to parathyroid hormone-related peptide (PTHrP) secretion or direct action of boney metastases although other mechanisms exist. Symptoms can be non-specific. Mild hypercalcaemia is associated with polyuria and polydipsia. Moderate hypercalcaemia with constipation and muscle weakness. Severe hypercalcaemia can lead to arrhythmias, pancreatitis and coma. Investigations include, calcium, albumin, phosphate and ALP levels. Mainstays of treatment involves IV fluid rehydration and bisphosphonates. Haemodialysis or use of a human monoclonal antibody denosumab maybe indicated in refractory cases.
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Excellent and easy to read summary of science and best clinical practice aimed at doctors
Clinically focussed advice from NICE with links to the literature that recommendations are based upon
Cancer Research UK advice page for patients about hypercalcaemia
Deeper Dive
A 2004 systematic review showing bisphosphonates normalise calcium in more than 70% of patients with hypercalcaemia of malignancy
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