Severe Hypercalcemia

Abstract

Hypercalcemia is a common clinical problem. The majority of patients with hypercalcemia are asymptomatic and are often diagnosed on routine laboratory studies. They do not typically require immediate treatment. In distinction to patients with mild hypercalcemia, patients with severe hypercalcemia are often symptomatic and usually require urgent admission and treatment. In addition to treating the acute hypercalcemia, the underlying cause must be investigated and treated when possible, to avoid ongoing or repeated episodes of severe calcium elevation. In over 90% of patients, the cause of hypercalcemia is either primary hyperparathyroidism or malignancy; other causes are far less common. The focus of this chapter is on the etiology of hypercalcemia and the presentation and treatment of severe hypercalcemia.