Hypercalcemia
From IDWiki
Differential Diagnosis
- High PTH
- Primary hyperparathyroidism
- Parathyroid adenoma (most common)
- Tertiary hyperparathyroidism
- Familial hypocalciuric hypercalcemia (FHH)
- Primary hyperparathyroidism
- Low PTH
- Malignancy
- HHM (PTHrP): squamous cell carcinomas
- alpha-1 hydroxylase: lymphoma
- Local osteolysis: multiple myeloma
- Bony metastases: breast cancer
- Granulomatous disease (alpha-1 hydroxylase)
- Tuberculosis
- Sarcoidosis
- Nutritional
- Hypervitaminosis A
- Hypervitaminosis D
- Milk-alkali syndrome
- Total parenteral nutrition
- Thyrotoxicosis
- Prolonged immobilization
- Malignancy
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
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.
