Clinical Picture of Humoral Hypercalcemia of Malignancy

Abstract

Hypercalcemia is generally the symptom of a disease which requires treatment. Only in rare conditions such as hypocalciuric hypercalcemia or truly asymptomatic, nonprogressive primary hyperparathyroidism is observation of hypercalcemia without treatment justified. In such cases, hypercalcemia is mild. Severely elevated plasma levels regardless of the underlying disease cause symptoms which are summarized as the “hypercalcemic syndrome” (Table 1). All such symptoms are functional and can be reversed by lowering calcium levels to normal. Single symptoms are not enough to diagnose a disease, but the more disturbances that are present in the patient, the more a plasma calcium determination is necessary to exclude hypercalcemia. Hypercalcemia is still not a common finding even in hospital patients although its frequency may vary between 0.6% (Shek et al. 1990) and 3.6% (Keating et al. 1969).