Hypercalcaemia

Last updated: Monday, 13, December, 2010
CausesAppropriate Tests

Hypercalcaemia may need to be verified and common artefacts excluded, by collecting a fasting blood specimen without using a tourniquet (stasis-free); see Table 1. Artefactual results.

Calcium (total); albumin, calcium (corrected); calcium (ionised) if presence of true hypercalcaemia is doubtful.

Further assessment should include phosphate, electrolytes, creatinine, urea, ALP; FBC; ESR.

Artefactual result

See above, and Table 1. Artefactual results.

Hyperparathyroidism

Parathyroid hormone (PTH) - serum.

Carcinoma

  • With bone metastases

Review clinical findings, FBC, blood film.

See also Leucoerythroblastic anaemia.

  • Without bone metastases (humoral hypercalcaemia)

Review clinical findings for evidence of primary tumour.

Parathyroid hormone related protein, if diagnosis uncertain or if indicated as a tumour marker for monitoring therapy.

  • Lung
  • Kidney
  • Pancreas

Multiple myeloma

Lymphoma

Vitamin D toxicity

Vitamin D ( 25-hydroxy ) if vitamin D2 or D3 taken; Vitamin D (1,25-dihydroxy) if calcitriol taken.

Vitamin A toxicity

Vitamin A.

Granulomas, especially 

Familial hypocalciuric hypercalcaemia

Calcium - urine.

High bone turnover states, especially