Diagnostic Tests for Hypercalcemia

Diagnostic Test list for Hypercalcemia:

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Hypercalcemia includes:

• Blood tests
  • Full blood count and ESR
  • Electrolytes, including calcium and phosphate levels ( elevated phosphate levels are common with hyperparathyroidism)
  • Renal function tests
  • Liver function tests, including albumin level
  • PTH level - If increased this would suggest parathyroid tumor, parathyroid hyperplasia or ectopic PTH secretion.
  • Alkaline phosphatase level - Elevated calcium and elevated alkaline phosphatase without elevated PTH suggests bone metastases, Paget's disease and other bone tumor. Elevated calcium without elevated alkaline phosphatase suggests multiple myeloma and elevated protein due to other causes.
  • Thyroid function tests looking for hyperthyroidism which may cause elevated calcium due to high bone turnover states
  • Serum protein electrophoresis will help detect multiple myeloma
  • Vitamin D and Vitamin A levels, if suspect Vitamin D or A toxicity as may cause elevated calcium levels
• Urine tests
  • 24 hour urinary calcium level
  • Protein electrophoresis will detect light chain (Bence Jones) proteins in Multiple myeloma
• Radiological investigations
  • Skeletal survey to detect bone lesions, if suspect Multiple myeloma
  • Bone scan, if suspect bone metastases or other bone tumors
  • Parathyroid ultrasound scan may detect larger parathyroid tumors
  • CT Scan or MRI parathyroid are more sensitive with detecting parathyroid tumors
  • Abdominal X-Ray may show kidney stones which may be a result of elevated calcium
  • Transbronchial biopsy - may be necessary to rule out sarcoidosis, if suspected.
• Blood calcium level tests

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