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The incidence and causes of hypercalcaemia
D M Dent1, J L Miller, L Klaff
1Department of Surgery, University of Cape Town, South Africa.
Postgraduate Medical Journal
|September 1, 1987
Summary
This study screened 58,053 patients for hypercalcaemia, finding a 0.6% incidence. Malignancy and primary hyperparathyroidism were the main causes of sustained hypercalcaemia.
Area of Science:
- Clinical Medicine
- Endocrinology
- Oncology
Background:
- Hypercalcaemia is a common electrolyte disturbance in hospitalized patients.
- Identifying the causes of hypercalcaemia is crucial for appropriate patient management.
- Prospective screening can reveal the true incidence and etiological spectrum of hypercalcaemia.
Purpose of the Study:
- To determine the incidence of hypercalcaemia in a large hospital inpatient population.
- To identify the primary causes of sustained hypercalcaemia.
- To assess the contribution of a prospective screening program to the diagnosis of primary hyperparathyroidism.
Main Methods:
- A prospective screening for hypercalcaemia was performed over 12 months.
- Involved a cohort of 58,053 hospital inpatients.
- Causative factors were analyzed in patients with sustained hypercalcaemia.
Main Results:
- The overall incidence of hypercalcaemia was 0.6%.
- Transient hypercalcaemia occurred in 19.2% of affected patients.
- Sustained hypercalcaemia was most commonly caused by malignancy (45%) and primary hyperparathyroidism (16.5%).
- The incidence of primary hyperparathyroidism was 78 per 100,000 inpatients.
- Over half of primary hyperparathyroidism cases were discovered due to the screening.
Conclusions:
- Hypercalcaemia affects a small but significant proportion of hospital inpatients.
- Malignancy and primary hyperparathyroidism are the leading causes of sustained hypercalcaemia.
- Prospective screening effectively identifies cases of primary hyperparathyroidism, highlighting its utility in clinical practice.