Hypercalcemia: Difference between revisions
From IDWiki
Content deleted Content added
linkified |
No edit summary |
||
| Line 30: | Line 30: | ||
***[[Milk-alkali syndrome]] |
***[[Milk-alkali syndrome]] |
||
***[[Total parenteral nutrition]] |
***[[Total parenteral nutrition]] |
||
**Endocrine |
|||
**[[Thyrotoxicosis]] |
***[[Thyrotoxicosis]] |
||
| ⚫ | |||
***[[Pheochromocytoma]], including in [[MEN-2]] or via production of PTH-RP |
|||
***[[Adrenal insufficiency]], rarely |
|||
**Medication: thiazide diuretics, prolonged retinoic acid, calcium carbonate (causing [[milk-alkali syndrome]]) |
|||
| ⚫ | |||
**Many other rare causes[[CiteRef::motlaghzadeh2021ra]] |
|||
[[Category:Endocrinology]] |
[[Category:Endocrinology]] |
||
Latest revision as of 21:16, 2 March 2026
Background
Pathophysiology
- Vitamin D is absorbed from GI tract
- First hydroxylation to 25-OH vitamin D in liver
- Second hydroxylation to 1,2-OH vitamin D in kidneys by alpha-1 hydroxylase
- PTH from parathyroid glands
- Calcitriol is involved somewhere
Differential Diagnosis
- High PTH
- Low PTH
- Malignancy
- Humoural hypercalcemia of malignancy (HHM): mediated by PTHrP, and most common in squamous cell carcinomas
- alpha-1 hydroxylase: lymphoma
- Local osteolysis: multiple myeloma
- Bony metastases: breast cancer
- Granulomatous disease (alpha-1 hydroxylase)
- Nutritional
- Endocrine
- Thyrotoxicosis
- Pheochromocytoma, including in MEN-2 or via production of PTH-RP
- Adrenal insufficiency, rarely
- Medication: thiazide diuretics, prolonged retinoic acid, calcium carbonate (causing milk-alkali syndrome)
- Prolonged immobilization, rarely
- Many other rare causes1
- Malignancy
References
- ^ Yasaman Motlaghzadeh, John P Bilezikian, Deborah E Sellmeyer. Rare Causes of Hypercalcemia: 2021 Update. The Journal of Clinical Endocrinology & Metabolism. 2021;106(11):3113-3128. doi:10.1210/clinem/dgab504.
