Hypercalcemia

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Endocrine glands

Treatment is directed at the underlying cause of hypercalcemia whenever possible. In cases of hyperparathyroidism, surgery may be needed to remove the abnormal parathyroid gland and cure the hypercalcemia.

When hypercalcemia is mild and caused by primary hyperparathyroidism, patients may be followed closely by their doctor over time. A new medication named cinacalcet has been shown to lower calcium levels in the blood by reducing parathyroid hormone production.

Severe hypercalcemia causing symptoms and requiring hospitalization is treated aggressively with the following:

• Intravenous fluids
• Bisphosphonates (drugs that stop bone breakdown and absorption by the body, such as pamidronate or etidronate)
• Calcitonin
• Glucocorticoids (steroids, for hypervitaminosis D that is not medication-related)
• Hemodialysis (for hypercalcemia that is unresponsive to treatment and is life-threatening)

Prognosis depends on the underlying cause of hypercalcemia. Patients with mild hyperparathyroidism or hypercalcemia with a treatable cause (for example, primary hyperparathyroidism, dietary hypervitaminosis D) may not suffer complications from hypercalcemia.

Patients with hypercalcemia secondary to conditions such as cancer or granulomatous disease may have a poor prognosis due to the underlying disease itself rather than to the hypercalcemia. The complications of prolonged hypercalcemia are uncommon today.

Skeletal

• Fractures
• Osteoporosis
• Bone cysts

Kidney

• Nephrocalcinosis (calcification of the kidney)
• Kidney stones
• Dehydration
• Kidney failure

Gastrointestinal

• Pancreatitis
• Peptic ulcer disease
• Hypertension

Psychosocial

• Difficulty concentrating or thinking
• Depression

Contact your physician or health care provider if you have a family history of hypercalcemia, family history of hyperparathyroidism, or if symptoms of hypercalcemia occur.

Review Date: 05/12/2006
Reviewed By: Robert Hurd, MD, Department of Biology, College of Arts and Sciences, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.