Hypercalcemic factors other than parathyroid hormone-related protein

Hypercalcemia of malignancy is caused by different mechanisms in different types of tumors. In most solid tumors, increased bone resorption and decreased urine calcium excretion are responsible. However, in myeloma, increased bone resorption and decreased glomerular filtration are the cause. In most solid tumors, factors working in conjunction cause the hypercalcemic syndrome. In addition to PTHrP, these include transforming growth factor alpha, interleukin-1, tumor necrosis factor, and lymphotoxin.