| Abstract: |
Hypercalcemia, a common medical condition, is due mainly to primary hyperparathyroidism or malignancy. Together they constitute about 90% of all cases. The remaining 10% is due to a long list of other etiologies. In general, the hypercalcemias can be divided into those in which parathyroid hormone (PTH) is abnormally secreted (e.g., primary hyperparathyroidism) and those in which PTH is suppressed (e.g., hypercalcemia of malignancy). Treatment of hypercalcemia depends upon the presence of symptoms and the actual level of the serum calcium. If the hypercalcemia is mild, emergency measures are rarely indicated. For moderate to severe hypercalcemia (e.g., serum calcium greater than 12 mg/dL), more proactive approaches are usually necessary. They consist of intravenous hydration with saline and, if necessary to guard against fluid overload, a loop diuretic once hydration has been established. Specific inhibitors of the osteoclast, the usual pathophysiologic culprit, focuses upon calcitonin and more potent inhibitors of bone resorption such as pamidronate, zoledronic acid, or denosumab. © 2022 Elsevier Inc. |
