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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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Calcium and phosphate are essential electrolytes in the human body, with calcium being the most abundant mineral. Around 99% of the body's calcium is stored in the skeleton and teeth, forming a crystal lattice of mineral salts in combination with phosphates. Calcium plays crucial roles in various bodily functions such as blood clotting, neurotransmitter release, muscle tone maintenance, and nervous and muscle tissue excitability.
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Rare Causes of Hypercalcemia.

Federica Saponaro1

  • 1Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, via Roma 55, Pisa 56126, Italy.

Endocrinology and Metabolism Clinics of North America
|November 14, 2021
PubMed
Summary

This article explores uncommon causes of hypercalcemia, a condition of high calcium levels. It highlights rare associations including genetic disorders, medical procedures, and intoxication, offering insights into unusual presentations of this metabolic imbalance.

Keywords:
Hypercalcemia in childrenImmobilizationMilk-alkali syndromeRare hypercalcemiaWilliams syndrome

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Area of Science:

  • Endocrinology
  • Genetics
  • Toxicology

Background:

  • Hypercalcemia, characterized by elevated serum calcium levels, is typically associated with common causes like primary hyperparathyroidism and malignancy.
  • However, a spectrum of less frequent etiologies can also lead to this condition, necessitating a broad differential diagnosis.

Purpose of the Study:

  • To review and delineate rare causes of hypercalcemia.
  • To enhance clinical awareness of unusual conditions presenting with hypercalcemia.

Main Methods:

  • Literature review of rare hypercalcemia causes.
  • Synthesis of clinical information on identified rare etiologies.

Main Results:

  • Rare causes include immobilization, genetic disorders (Williams-Beuren syndrome, Hypophosphatasia, Jansen Metaphyseal Chondrodysplasia), cosmetic injections, milk-alkali syndrome, calcium sulfate administration, manganese intoxication, post-acute kidney failure recovery, and Paget's disease.

Conclusions:

  • Recognizing these uncommon causes is crucial for accurate diagnosis and management of hypercalcemia.
  • A comprehensive understanding of rare etiologies aids in avoiding diagnostic delays and inappropriate treatments.