Hypercalcemia of malignancy

High calcium (Ca2+) level in the blood serum

Hypercalcaemia
Synonyms	Hypercalcemia
Pronounce	N/A
Field	Endocrinology
Symptoms	Abdominal pain, bone pain, confusion, depression, weakness<ref name=BMJ2015/><ref name=EU2010/>
Complications	Kidney stones, abnormal heart rhythm, cardiac arrest<ref name=BMJ2015/><ref name=EU2010/>
Onset
Duration
Types
Causes	Primary hyperparathyroidism, cancer, sarcoidosis, tuberculosis, Paget disease, multiple endocrine neoplasia, vitamin D toxicity<ref name=BMJ2015/><ref name=PMH2016/>
Risks
Diagnosis	Blood serum level > 2.6 mmol/l (corrected calcium or ionized calcium)<ref name=BMJ2015/><ref name=EU2010/>
Differential diagnosis
Prevention
Treatment	Underlying cause, intravenous fluids, furosemide, calcitonin, pamidronate, hemodialysis<ref name=BMJ2015/><ref name=EU2010/>
Medication
Prognosis
Frequency	4 per 1,000<ref name=BMJ2015/>
Deaths

Hypercalcemia generally develops as a late complication of malignancy; its appearance has grave prognostic significance.

Pathophysiology

It remains unclear, however, whether death is associated with hypercalcemic crisis (uncontrolled or recurrent progressive hypercalcemia) or with advanced disease.

Symptoms

Symptoms include central nervous system impairment such as delirium with prominent symptoms of personality change, cognitive dysfunction, disorientation, incoherent speech, and psychotic symptoms such as hallucinations and delusions, smooth muscle hypotonicity, and altered cardiovascular function.

Treatment is similar to the treatment of hypercalcemia plus treatment of the underlying malignancy.

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