Treatment Guideline Chart
Hypercalcemia is having serum calcium level of >10.5 mg/dL (>2.5 mmol/L).
Mild hypercalcemia is usually asymptomatic. While, more severe hypercalcemia has a constellation of clinical manifestations commonly described as "bones, abdominal moans, stones & groans."
Etiologies may be parathyroid-dependent or parathyroid independent.
Surgery is the treatment of choice for hypercalcemic patients with classic symptoms or complications of primary hyperparathyroidism.

Hypercalcemia References

  1. Bilezikian JP, Potts JT, Fuleihan GE, et al. Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Clin Endocrinol & Metab. 2002 Dec;87(12):5353-5361. PMID: 12466320
  2. AACE/AAES Task Force on Primary Hyperparathyroidism. The American Association of Clinical Endocrinologists and the American Association of Endocrine Surgeons position statement on the diagnosis and management of primary hyperparathyroidism. Endocr Pract. 2005 Jan;11(1):49-54. PMID: 16033736
  3. Bilezikian JP, Siverberg SJ. Asymptomatic primary hyperthyroidism [clinical practice]. N Engl J Med. 2004 Apr;350(17):1746-1751. PMID: 15103001
  4. Bushinsky DA, Monk RD. Electrolyte quintet: calcium. Lancet. 1998 Jul;352(9124):306-311. PMID: 9690425
  5. National Institutes of Health. Diagnosis and management of asymptomatic primary hyperthyroidism. NIH Consens Statement. 1990 Oct;8(7):001-18
  6. Kearns AE, Thompson GB. Medical and surgical management of hyperparathyroidism. Mayo Clin Proc. 2002 Jan;77(1):87-91. PMID: 11794462
  7. Eigelberger MS, Clark OH. Surgical approaches to primary hyperparathyroidism. Endocrinol Metab Clin North Am. 2000 Sep;29(3):479-502. PMID: 11033757
  8. Deftos LJ. Hypercalcemia in malignant and inflammatory diseases. Endocrinol Metab Clin North Am. 2002 Mar;31(1):141-158. PMID: 12055985
  9. Silverberg SJ, Shane E, Jacobs TP, et al. A 10 year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med. 1999 Oct;341(17):1249-1255. PMID: 10528034
  10. Rudock AS. Secondary hyperparathyroidism-current concepts and controversies. Clin Fam Pract. 2002 Sep;4(3):639-642
  11. Strewler GJ. Medical approaches to primary hyperparathyroidism. Endocrinol Metab Clin North Am. 2000 Sep;29(3):523-539. PMID: 11033759
  12. Ziegler R. Hypercalcemic crisis. J Am Soc Nephrol. 2001 Feb;12(Suppl 17):S3-S9. PMID: 11251025
  13. Diseases of the parathyroid gland and other hyper- and hypocalcemic disorders. Harrison's Online: McGraw-Hill Companies; 2003.
  14. Bringhurst FR, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. William's Textbook of Endocrinology. 10th ed. Philadelphia: Saunders, an imprint of Elsevier; 2003:1336-1339
  15. Mundy GR, Stewart AF. Calcium and common bone disorders. Comprehensive clinical endocrinology. 3rd ed. London: Mosby; 2002
  16. MedWormhttp://www.medworm.com/rss/index.php/Endocrinology/15/http://www.medworm.com/rss/medicalfeeds/specialities/Endocrinology.xml
  17. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  18. Agraharkar M, Dellinger OD, Gangakhedkar AK. Hypercalcemia. http://emedicine.medscape.com/article/240681-overview. 2006
  19. Hypercalcemia. ARUP Consult. http://www.arupconsult.com/Algorithms/Hypercalcemia.pdf/. 16 May 2011.
  20. Brown EM. Disorders of the calcium-sensing receptor: familial hypocalciuric hypercalcemia and autosomal dominant hypocalcemia. UpToDate. www.uptodate.com/contents/ disorders-of-the-calcium-sensing-receptor-familialhypocalciuric- hypercalcemia-and-autosomal-dominanthypocalcemia. Oct 2013.
  21. Society for Endocrinology. Acute hypercalcemia. Society for Endocrinology. http://www.endocrinology.org/policy/docs/13-02_ EmergencyGuidance-AcuteHypercalcaemia.pdf. Feb 2013.
  22. Bringhurst FR, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Melmed S, Polonsky KS, Larsen PR, et al, eds. Williams textbook of endocrinology. 13th. Philadelphia, PA: Elsevier; 2016. 1294. :1294.
  23. Shane E, Berenson JR. Treatment of hypercalcemia. UpToDate. www.uptodate.com. May 2017.
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