Critical review of hypercalcemia

Hypercalcemia is a clinical condition with an abnormally high serum calcium (Ca) level. Hypercalcemia is associated with many diseases with primary hyperparathyroidism and some malignancies accounting for greater than 90% of cases. Hypercalcemia may be clinically useful as a diagnostic or prognostic marker for these diseases. This paper covers the various etiologies attributing to hypercalcemia, pathogenesis and the differential diagnosis of hypercalcemia. Hypercalcemia is a useful diagnostic marker in hypercalcemia-related diseases such as primary hyperparathyroidism, malignancies and granulomatous disorders. Adequate managements or treatments are aimed to reduce serum Ca levels by preventing bone resorption, enhancing urinary Ca excretion, or preventing intestinal Ca absorption. The optimal choice is dependent on the cause and/or severity of hypercalcemia. Drug treatment or management of hypercalcemia include: Bisphosphonates, Gallium nitrate, Glucocorticoids and Denosumab.