Causes of Hypercalcaemia

ENDOCRINE MALIGNANCY SARCOID DRUGS Ca INTAKE & MILK ALKALI

•1º/3º↑PTH •↑VitD •HyperT •Breast •Kidney •Thyroid •SqCC •Macrophages → 1,25VitD3 •Thiazides •Lithium

Two of commonest causes of hypercalcaemia in the western world are primary hyperparathyroidism and malignancy. In primary hyperparathyroidism there is excess production of parathyroid hormone (PTH); although usually from a benign adenoma, this sometimes results from hyperplasia of the parathyroid glands and, in rare cases, a carcinoma. Thyrotoxicosis can cause hypercalcaemia as well as osteoporosis. The milk–alkali syndrome can occur in patients who suffer from dyspepsia and drink milk and alkali­ containing antacids, which may reduce the renal excretion of calcium. Around one­fifth of those with sarcoid have increased calcium levels. Various mechanisms cause raised hypercalcaemia of malignancy. 

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