Calcium Excess (Hypercalcemia): Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Familial benign hypocalciuric hypercalcemia (FBHH)-rare, autosomal-dominant inherited disorder of calcium balance caused by an inactivating mutation of the calcium-sensitive receptor in the parathyroid gland and kidneys; childhood hypercalcemia; laboratory: normal PTH concentration, hypermagnesemia (magnesium excess), and low urine calcium/magnesium clearance

Blood, hematopoietic organs – immune system (D50-D90).

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Calcium-alkali syndrome (CAS; synonym: Burnett syndrome) – calcium metabolic disorder resulting from an excess of readily absorbable alkalis (e.g., as bicarbonates) and calcium (e.g., via milk).
  • Hyperthyroidism (hyperthyroidism)
  • Hypomagnesemia
  • Idiopathic hypercalcemia in childhood (William’s syndrome, developmental disorder).
  • Metabolic alkalosis – metabolic alkalosis; metabolic disorder characterized by an increase in bicarbonate or loss of hydrogen ions.
  • Addison’s disease (adrenocortical insufficiency).
  • Primary hyperparathyroidism (pHPT) – primary disease of the parathyroid glands with increased production of parathyroid hormone and resulting excess calcium [25% of cases].

Cardiovascular system (I00-I99)

Musculoskeletal system and connective tissue (M00-M99).

  • Paget’s disease (synonyms: Paget’s disease of bone) – disease of the skeletal system with bone remodeling; hypercalcemia here exclusively in bedriddenness due to immobilization.

Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87).

  • Constipation (constipation)

Neoplasms – tumor diseases (C00-D48) [tumor hypercalcemia; 65% of cases]

  • Bronchial carcinoma (lung cancer).
  • Lymphoma e.g. Hodgkin’s disease (malignant neoplasm (malignant neoplasm) of the lymphatic system with possible involvement of other organs)
  • Mammary carcinoma (breast cancer)
  • Monoclonal gammopathy – disease associated with an increase in monoclonal immunoglobulins or their parts (light or heavy chains) within the gamma fraction of serum proteins.
  • Plasmocytoma (multiple myeloma).
  • Prostate carcinoma (prostate cancer)

Psyche – nervous system (F00-F99; G00-G99)

  • Acute confusion
  • Delir

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Abnormal weight loss
  • Anuria – lack of urine output (maximum 100 ml/24 h).
  • Fatigue
  • Nocturia – urination at night
  • Oliguria – decreased amount of urine with a daily maximum of 500 ml.

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

More

  • Immobilization

Medication

  • Calcium-containing antacids
  • Hormones
  • Lithium
  • Thiazides (reduce the excretion of calcium).
  • Vitamin D supplements/vitamin D analogues
  • Vitamin A supplements