Hypercalcaemia : a finding not to be taken too lightly : review article

Extracted from text ... Review SA Fam Pract 2004;46(1) 33 INTRODUCTION Many conditions are associated with hypercalcaemia: primary hyperparathyroidism, advanced secondary hyperparathyroidism, milk alkali syndrome, vitamin D intoxication, thiazide diuretic treatment, malignancy with or without bone metastases, and immobilisation. Primary hyperparathyroidism (pHPT) is the most common cause in ambulatory adult patients, but malignancy in hospitalised patients.1 Primary hyperparathyroidism is characterised by excessive bone resorption, pain and tenderness of bones, spontaneous fractures, nephrolithiasis, hypercalcaemia, hypophosphataemia, and an elevated intact serum parathormone level in more than 90 % of patients. pHPT may be the result of hyperplasia of all the parathyroid glands, but in approximately 80 ..