A guide to the initial management of hypercalcaemia

A guide to the initial management of hypercalcaemia

Abstract

With the widespread use of multiple channel biochemical auto analysers hypercalcaemia has become a common incidental finding. The approach to managing a patient with hypercalcaemia requires an understanding of the principles of calcium homeostasis, knowledge of the potential differential diagnoses and the clinical judgement to know when therapy is appropriate. This article aims to provide a guide to the initial investigation and management of patients presenting with hypercalcaemia.
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References

  1. Klee G , Kao P, Heath H. (1988) Hypercalcaemia. Endocrin and metabolism clinics of North America. 17:573-600.
  2. Lee J-K, Chuang M-J, Lu C-C et al: Parathyroid hormone and parathyroid hormone related assays in hypercalcaemic patients in hospital in a Chinese population. Journ of End Invest 1997; 20: 405-9.
  3. Schaiff R, Hall T, Bar R.(1989) Medical treatment of hypercalcaemia. Clinical Pharmacy. 8:108-121.
  4. Lafferty F. (1991) Differential diagnosis of hypercalcaemia. Journal of bone and mineral research 6 suppl 51-59.
  5. Kristensen B, Ejlertsen b, Mouriden HT, et al: Survival in breast cancer patients after the first episode of hypercalcaemia. J of Int Med 1998; 244:189-198.
  6. Heath H (1989) Familial benign (hypocalciuric) hypercalcaemia. A troublesome mimic of mild primary hyperparathyroidism.. Endocrin & metabolism clinics of North America. 18:723-740.
  7. Sharma OP. Hypercalcaemia in granulomatous disorders: a clinical review. Current Opinion in Pulmonary Medicine 2000 Sep;6(5):442-7.
  8. Lee J-K, Chuang M-J, Lu C-C et al: Parathyroid hormone and parathyroid hormone related assays in hypercalcaemic patients in hospital in a chinese population. J of EndInvest 1997; 20: 405-9.
  9. Ratcliffe WA, Hutchesson AC, Bundred NJ et al: role of assays for parathyroidhormone relates protein in hypercalcaemia. Lancet 1992; 339: 164-7.
  10. Suki WN, Yium JJ, Mindem M, et al: Acute treatment of hypercalcaemia with furosemide. New England Journal of Medicine 1970; 2: 836-40.
  11. Schaiff R, Hall T, Bar R.(1989) Medical treatment of hypercalcaemia. Clinical Pharmacy. 8:108-121.
  12. Rizzoli R. Bonjour J. (1992) Management of disorders of calcium homeostasis. Baillieres clinical endocrinology & metabolism. 6:129-142.
  13. Nussbaum SR, Younger J, VandePol CJ, et al: Single dose intravenous therapy with pamidronate for the treatment of hypercalcaemia of malignancy: Comparison of 30-,60- and 90mg doses. American Journal of Medicine 1993; 95:297-304.
  14. Ralston S.(1992) Medical management of hypercalcaemia. British Journal of Clinical Pharmacology. 34:11-20.
  15. Greenspan F, Strewler G. Basic and Clinical Endocrinology (5th Edition). Appleton and Lange 1997; chapter 8: 285.
  16. Purohit OP, Radstone CR, Antony C, Kanis JA, Coleman RE. A randomised double-blind comparison of intravenous pamidronate and clondronate in the hypercalxaemia of malignancy. British Journal of Cancer 1995 Nov; 72(5):1289-93.
  17. Zojer N, Keck AV, Pecherstorfer M. Comparative tolerability of drug therapies for hypercalcaemia of malignancy. Drug Safety 1999 Nov; 21(5):389-406.
  18. Berenson J. (2002) Treatment of hypercalcaemia of malignancy with bisphosphonates. Seminars in Oncology. 29 suppl 21:12-18.
  19. Wimalawansa SJ : Optimal frequency of administration of pamidronate in patients with hypercalcaemia of malignancy. Clinical Endocrinology 1994; 41: 591-595.
  20. Kristensen B, Ejlertsen B, Holmegaard SN, et al: Prednisolone in the treatment of severe malignant hyoercalcaemia in metastatic breast cancer: a randomised study. J of Int Med 1992; 232: 237-245.
  21. Davidson TG: Conventional treatment of hypercalcemia of malignancy. Am J Health Sys Pharm 2001 Nov 15:58 Suppl 3: S8-15.
  22. Nussbaum SR: Pathophysiology and management of hypercalcaemia. Endocrin and Metabolism Clinics of North America. 1993;22: 343-62.
  23. Warrell RP, Murphy WK, Schulman P, et al: A randomised double-blind study of Gallium Nitrate compared with Etidronate for control of cancer-related hypercalcaemia. Journal of Clinical Oncology 1991; 0(8): 1467-1475.

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A guide to the initial management of hypercalcaemia

11th February 2016
Authors Affiliations
J.P. Macklin Specialist Registrar in General Medicine Ninewells Hospital, Dundee DD1 9SY
F.C. Green Specialist Registrar in Endocrinology Ninewells Hospital, Dundee DD1 9SY

A guide to the initial management of hypercalcaemia

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A guide to the initial management of hypercalcaemia

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