Hypercalcaemia is an elevated calcium level in the blood. It can be an asymptomatic laboratory finding, but because an elevated calcium level is often a clue to other serious disease, a diagnosis should be undertaken if it persists.
Hypercalcemia per se can result in fatigue, depression, confusion, anorexia, nausea, vomiting, constipation, or increased urination; if it is chronic it can result in urinary calculi (renal stones or bladder stones). Abnormal heart rhythms can result, and an EKG finding of a short QT interval suggests hypercalcemia. Symptoms are more common at high calcium levels (12.0 mg/dL or 3 mmol/l). Severe hypercalcemia (above 15-16 mg/dL or 3.75-4 mmol/l) is considered a medical emergency: at these levels, coma and cardiac arrest can result.
Definitive treatment is directed at the underlying cause. Emergency treatment consists of intravenous hydration, increased salt intake, use of diuretics, and in extreme cases such drugs as biphosphonates or calcitonin.
It can be an asymptomatic laboratory finding, but because an elevated calcium level is often a clue to other serious disease, a diagnosis should be undertaken if it persists.
Humoral hypercalcemia is mediated by circulating factors secreted by malignant cells without evidence of bony disease.[5,6] It is now believed that hypercalcemia is due to the release of factors by malignant cells that ultimately cause calcium reabsorption from bone.[1] One such factor is a PTH-like protein known as parathyroid hormone-related protein or peptide (PTHrP).
Rapid diagnosis of hypercalcemia may be complicated because symptoms associated with hypercalcemia are characteristically nonspecific and are easily attributed to chronic or terminal illness.[1,2] Symptom severity may be due in part to confounding factors such as previous cancer treatment, drug-disease state interactions, or comorbid pathologies.
Symptoms of hypo- or hypercalcemia are due to abnormalities in the ionized fraction of the plasma calcium concentration.
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