Hypercalcemia is rare in hospitalized patients, occurring at a reported rate of less than 1% of patients in this country. Hypercalcemia is the result of excessive skeletal calcium release, increased intestinal calcium absorption, or inadequate excretion of calcium. The two most common conditions that account for 90% of patients with hypercalcemia are primary hyperparathyroidism and cancer. Malignancies such as multiple myeloma, lymphoma, and metastatic breast cancer can invade bone and cause direct bone reabsorption leading to hypercalcemia. Other malignancies can release parathyroid hormone-like substances that cause hypercalcemia. Rarer causes of hypercalcemia include use of thiazide diuretics, lithium therapy, excessive vitamin D intake, immobilization, hyperthyroidism, and complicated renal failure.
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