It is the elevation of blood calcium levels above the normal value (10.5 mg/dL). Calcium is involved in many enzymatic reactions of metabolism as well as in the regulation of muscle contraction.
The most common causes are: excess of parathyroid gland hormones, tumors, alterations of renal function and drugs that cause an excess of Vitamin D.
It manifests with muscular fatigue, mental alterations (anxiety, depression, stupor, coma), nausea, vomiting, abdominal pain, constipation, bone alterations (pain, arthritis, osteoporosis, etc.), arterial hypertension and gout. Severe cases can cause alterations of the mental state, muscular alterations or severe digestive alterations.
Diagnosis is clinical, by interrogation and physical examination. It is confirmed by blood tests that show elevated calcium concentration.
The triggering cause should be treated and the blood calcium concentration should be lowered by abundant hydration and diuretics. Once the cause has been treated, treatment with bisphosphonates and calcitonin will be added.
- Elizabeth Shane, MD. Etiology of hypercalcemia. UpToDate Apr 29, 2015.
- Elizabeth Shane, MD. Clinical manifestations of hypercalcemia. UpToDate. Aug 05, 2016.
- Shane, E, Dinaz, I. Hypercalcemia: Pathogenesis, clinical manifestations, differential diagnosis, and managment. In: Favus, MJ, ed. Primer on the metabolic bone diseases and disorders of mineral metabolism. Sixth ed. Philadelphia: Lippincott, Williams, and Wilkins. 2006; 26:176.
- Khosla S. Hipercalcemia e hipocalcemia. Harrison. Principios de Medicina Interna. Volumen 1. 19º Edición: 313-315.
- Potts JT. Jüppner H. Trastornos de las glándulas paratiroides y la homeostasis del calcio. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición: 2469-2482.
