Hypercalcaemia

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

Calcium Excess (Hypercalcemia): Complications

The following are the most important diseases or complications that may be contributed to by hypercalcemia: Cardiovascular system (I00-I99). Cardiac arrhythmias (arrhythmia, bradycardia (heartbeat too slow: < 60 beats per minute)). Hypertension (high blood pressure) Valve calcifications Liver, gallbladder and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87). Pancreatitis (inflammation of the pancreas). Mouth, esophagus (esophagus), … Calcium Excess (Hypercalcemia): Complications

Calcium Excess (Hypercalcemia): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Oral cavity Pharynx (throat) Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin … Calcium Excess (Hypercalcemia): Examination

Calcium Excess (Hypercalcemia): Test and Diagnosis

1st-order laboratory parameters-obligatory laboratory tests. Electrolytes – calcium in serum/albumin or alternatively ionized calcium. Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification. Parathyroid hormone [↑], inorganic phosphate [in serum ↓; in urine ↑], alkaline phosphatase [↑ if bone involvement] – suspected hyperparathyroidism, primary … Calcium Excess (Hypercalcemia): Test and Diagnosis

Calcium Excess (Hypercalcemia): Drug Therapy

Therapeutic target Correction of hypercalcemia Therapy recommendations Treatment of the underlying cause (e.g., primary hyperparathyroidism). In symptomatic hypercalcemia (usually above 11.5 mg/dl (≥ 2.9 mmol/l)), blood calcium levels should be lowered. The following therapy recommendations apply in tumor hypercalcemia as well as in hypercalcemic crisis (total serum calcium of >3.5 mmol/l): Rehydration: 2-4 l NaCl … Calcium Excess (Hypercalcemia): Drug Therapy

Calcium Excess (Hypercalcemia): Medical History

Medical history (history of illness) represents an important component in the diagnosis of hypercalcemia. Family history Are there any diseases in your family that are common? (Tumor diseases; multiple endocrine neoplasia/MEN I (primary hyperparathyroidism (pHPT), gastroenteropancreatic neuroendocrine tumors (GEP-NET), pituitary tumors) and MEN II (medullary thyroid carcinoma, pheochromocytoma, pHPT)). Are there any hereditary diseases in … Calcium Excess (Hypercalcemia): Medical History

Calcium Excess (Hypercalcemia): Symptoms, Complaints, Signs

Hypercalcemia is usually discovered incidentally by laboratory diagnosis before the development of symptoms. The following symptoms and complaints may indicate hypercalcemia: Eyes Cornea (cornea of the eye): band-like degeneration. Heart Shortened QT time in ECG Cardiac arrhythmias (arrhythmia, bradycardia (heartbeat too slow: < 60 beats per minute)). Hypertension (high blood pressure) Valve calcifications Gastrointestinal tract … Calcium Excess (Hypercalcemia): Symptoms, Complaints, Signs

Calcium Excess (Hypercalcemia): Therapy

In symptomatic hypercalcemia (usually above 11.5 mg/dl (≥ 2.9 mmol/l)), blood calcium levels should be lowered (see “Drug Therapy” below). A hypercalcemic crisis (total serum calcium of > 3.5 mmol/l) is an emergency associated with the following symptoms: polyuria (increased urination), desiccosis (dehydration), hyperpyrexia (extreme fever: higher than 41 °C), cardiac arrhythmias, weakness and lethargy, … Calcium Excess (Hypercalcemia): Therapy