[Clinical significance of asymptomatic hypercalcemia]

Since automated multichannel analyzers have been introduced in the clinical laboratory the diagnosis of hypercalcemia is frequently accidental. The clinical significance of asymptomatic hypercalcemia is discussed on the basis of the differential diagnosis of hypercalcemia. In no disease, and especially not in malignancy and primary hyperparathyroidism, which are the two most frequent causes, is asymptomatic hypercalcemia clinically relevant, and further diagnostic tests should be avoided. Up to now it has not been demonstrated that patients with asymptomatic hyperparathyroidism benefit from surgery. Instead of routine estimations of serum calcium concentration, the aim should be to detect symptomatic hypercalcemia on the basis of a thorough knowledge of the hypercalcemia syndrome with all its variants.