Definition
> 10 mg / dl
- must be corrected for albumin
Causes
Malignancy
- multiple myeloma / lung cancer / breast cancer
Hyperparathyroidism
- elevated PTH
Issue
High mortality associated with hypercalcaemia of malignancy
Physiology
40% albumin bound
50% ionised and active
Symptoms
Lethargy / confusion
- most commonly seen in malignancy
Kidney stones / abdominal pain / depression
- more likely seen in hyperparathyroidism
Management
Admit patient for medical management
Forced diuresis
- fluids + frusemide / loop diuretic
Bisphosphonates
- IV dose
Calcitonin
- gives rapid but short lived reduction
- need to be coadministered with other medications
Dialysis
- required if kidneys unable to cope with fluid diuresis / renal failure