Causes of hypercalcemia

Answer: a, b, d


Multiple causes of hypercalcemia include the following:

• Malignancy
• Vitamin A or D intoxication
• Thiazide diuretics
• Hyperthyroidism
• Milk-alkali syndrome
• Sarcoidosis and other granulomatous diseases
• Familial hypocalciuric hypercalcemia
• Immobilization
• Paget’s disease
• Lithium therapy
• Addisonian crisis
• Idiopathic hypercalcemia of infancy

Hyperthyroidism is associated with increased bone reabsorption. Often, the plasma PTH is low, and a history of other thyrotoxic symptoms can be elicited. Thiazides may increase serum calcium to a mild degree, primarily through hemoconcentration. Serum phosphate may also be depressed. It often takes several weeks for the hypercalcemia to resolve after the medication is discontinued. Terminal ileal resection is not associated with hypercalcemia, indeed hypocalcemia may develop with short gut syndrome. While ileal resection is a predisposing condition for the development of calcium oxalate kidney stones, this is the result of alterations in oxalate metabolism. Patients with solid tumors, such as lung carcinoma, breast carcinoma, squamous cell carcinoma of the head, neck, esophagus or female genital tract or renal cell cancer account for three quarters of all cases of humoral hypercalcemia of malignancy.

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