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Pathophysiology of Hypercalcemia.

David Goltzman1

  • 1Calcium Research Laboratory, Department of Medicine and Physiology, McGill University, Research Institute of the McGill University Health Centre, Glen Site, 1001 Decarie Boulevard, Room EM1.3220, Montreal, Quebec H4A 3J1, Canada.

Endocrinology and Metabolism Clinics of North America
|November 14, 2021
PubMed
Summary
This summary is machine-generated.

Hypercalcemia, or high blood calcium, results from dysregulated parathyroid hormone (PTH) or PTH-related protein. Various conditions, including malignancy and inflammatory disorders, can cause these imbalances.

Keywords:
HypercalcemiaParathyroid hormoneParathyroid hormone-related proteinVitamin D

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Area of Science:

  • Endocrinology
  • Calcium Homeostasis
  • Oncology

Background:

  • Extracellular calcium is tightly regulated by parathyroid hormone (PTH), 1,25-dihydroxyvitamin D, and calcium ions.
  • Dysregulated PTH production causes hypercalcemia, most commonly in primary hyperparathyroidism (PHPT) or genetic disorders.
  • PTH-related protein and other mediators can also cause hypercalcemia, particularly in malignancy.

Purpose of the Study:

  • To review the common and less common causes of hypercalcemia.
  • To discuss the roles of parathyroid hormone (PTH), PTH-related protein, and calcitriol in calcium dysregulation.
  • To highlight the association of hypercalcemia with malignancy and inflammatory conditions.

Main Methods:

  • Literature review of studies on calcium regulation and hypercalcemia.
  • Analysis of the molecular mechanisms of PTH and PTH-related protein.
  • Examination of etiological factors contributing to hypercalcemia.

Main Results:

  • Primary hyperparathyroidism (PHPT) and PTH-related protein are leading causes of hypercalcemia.
  • Bone metastases and associated cytokines contribute to resorptive hypercalcemia.
  • Extrarenal calcitriol production in malignancies and inflammatory conditions is a less common cause.

Conclusions:

  • Hypercalcemia arises from complex hormonal and cellular interactions.
  • Understanding these mechanisms is crucial for diagnosing and managing hypercalcemia.
  • Malignancy and inflammatory diseases represent significant contributors to hypercalcemia.