[Treatment of hypercalcaemia]

Area of Science:

• Endocrinology
• Nephrology
• Oncology

Background:

• Hypercalcemia, elevated serum calcium, requires prompt etiological identification for effective management.
• Treatment strategies for hypercalcemia vary significantly based on the underlying cause and parathyroid hormone (PTH) levels.

Purpose of the Study:

• To outline the diagnostic approach to hypercalcemia.
• To detail the primary treatment modalities for hypercalcemia based on its etiology.

Main Methods:

• Review of common causes of hypercalcemia stratified by PTH levels.
• Description of established treatment options for different hypercalcemia etiologies.

Main Results:

• Elevated PTH: Primary hyperparathyroidism (surgery) and thiazide diuretics (discontinuation) are common. Cinacalcet can lower calcium preoperatively.
• Low PTH: Dehydration, malignancy, and calcium supplementation are frequent causes. Malignant hypercalcemia is managed with prednisone, bisphosphonates, or denosumab.

Conclusions:

• Accurate diagnosis of hypercalcemia's root cause is crucial for selecting appropriate therapeutic interventions.
• Treatment involves addressing the underlying condition, rehydration, and specific pharmacotherapies like bisphosphonates or denosumab for malignancy-associated hypercalcemia.