Management of Acute Hypercalcemia

HYPERCALCEMIA is a relatively frequent medical problem. Among its many causes (Table 1), by far the most common are cancer and primary hyperparathyroidism.4 Hypercalcemia requiring urgent attention is most often caused by the former, but it can be caused by the latter (parathyroid crisis) or, rarely, by the other disorders listed in Table 1. Distinguishing between cancer-related hypercalcemia and primary hyperparathyroidism is usually not difficult, and the diagnosis is readily confirmed by measurements of serum parathyroid hormone. Most patients with primary hyperparathyroidism have elevated serum concentrations of parathyroid hormone, whereas virtually all patients with cancer-associated hypercalcemia have low concentrations.5 Hypercalcemia in patients . . .