Hypercalcemia 

mild 

might be asymptomatic - symptoms: polyuria/ polydipsia / abdominal pain / kidney stones / fatigue / depression 

work up 

possible causes : 

Albumin : 

low albumin can cause falsefully high calcium 

1g -> 0.2 mmol

PO4 

high phosphate : low ALP or high ALP 

• low ALP : malignancy / bone tumor 

• high ALP : hypervitamin D 

normal or low PO4 

=========

• primary hyperparathyroid 

• Family high hyperparathyroid

Treatment: 

hydration 4-6 Litre with furosemide 

malignancy : reduce bone reabsorption by zolendronate acid 4mg over 30 min 

pamdrinote 

biphosphate 

Cinacalcet if hypercalcemia secondary to hyperparathyroidism 

Hyperparathyroid

Primary 

Secondary