HYPERCALCEMIA

HYPERCALCEMIA: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the Following Questions:

1. Is the PTH assay increased? This would point to a parathyroid tumor or hyperplasia and ectopic PTH secretion.
2. Is the alkaline phosphatase elevated? Hypercalcemia and an increased alkaline phosphatase without an increase in PTH assay suggests metastatic carcinoma of the bone, Paget's disease, and other bone tumors. Hypercalcemia without an elevated alkaline phosphatase is suggestive of multiple myeloma and hyperproteinemia due to other causes. A serum protein electrophoresis will help define this further.

DIAGNOSTIC WORKUP

A CBC, chemistry panel, 24-hr urine calcium, PTH assay, serum 25(OH) vitamin D3 , free tetraiodothyronine (thyroxine) (T ₄ ), serum protein electrophoresis, skeletal survey, bone scan, and endocrinology consult may be part of any workup of hypercalcemia.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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