Hypercalcemia—doubled Causes and a Dilemma

Excerpt Twelve years ago, Albright and Reifenstein set forth most of the now-known clinical causes of hypercalcemia in their monograph 1 on metabolic bone disease. Since then the list (Table 1) has grown only by the addition of "hyperthyroidism" and "neoplasm without skeletal lesions." Even the latter cause was anticipated by Albright in his case 5, "Hypernephroma with solitary metastasis to bone simulating hyperparathyroidism." But diagnosing the cause of an elevated serum calcium level has become an increasingly complex problem in the past decade, due to the appearance of cases with less overt signs and symptoms and of cases with multiple causes...