Hypercalcaemia is often thought to provide important clues to the presence of unsuspected illness. A presumptive diagnosis of hypercalcaemia may often be made on an elevated total serum calcium concentration although it should, strictly speaking, refer to an elevation in the physiologically important ionized (free) calcium concentration. Pseudohypercalcaemia is rare, but should be excluded befo...

A young man developed acute renal failure and hypercalcaemia following severe burns. The hypercalcaemia was initially controlled by haemodialysis, but it persisted after return of renal function. Plasma PTH was inappropriately elevated, but the nephrogenous cyclic adenosine monophosphate level was low; thus the PTH was probably not biologically active, and may have been artefactually elevated b...

AIM To investigate possible abnormalities of serum potassium and calcium levels in patients with essential thrombocythaemia and significant thrombocytosis. METHODS 24 cases of essential thrombocythaemia with significant thrombocytosis (platelet count > 700 x 10(9)/litre) had serum potassium and calcium estimations performed at the time of maximum thrombocytosis before treatment, and at the ti...

The prevalence and mechanisms of hypercalcaemia were studied in a series of patients attending a regional referral centre for rheumatic diseases. In a prospective study one case of hypercalcaemia due to primary hyperparathyroidism was found in 251 consecutive patients who were screened over a three month period. In a retrospective study of 39 patients who had been discovered to be hypercalcaemi...

UNLABELLED Adrenal insufficiency is a rare cause of hypercalcaemia and should be considered when more common causes such as primary hyperparathyroidism and malignancy are excluded. Opioid therapy as a cause of adrenal insufficiency is a possibly under-recognised endocrinopathy with potentially life-threatening adverse effects. We report on a case of opioid-induced secondary adrenal insufficienc...

We believe that hypercalcaemia after tamoxifen may signify tumour response and be a reason for continuing with tamoxifen and treating the hypercalcaemia. This is supported by a report of tamoxifen "flare" in metastatic breast cancer and the observation that acute exacerbation of bone pain in patients with breast cancer after tamoxifen may be associated with tumour response.'5 The mechanism of t...

Parathyroid carcinoma is rare and the associated hypercalcaemia is often resistant to all treatment. A case is described in which prolonged control of hypercalcaemia has been achieved by infrequent infusions of pamidronate despite continuing hypersecretion of parathyroid hormone.

Hypercalcaemia is ordinarily treated by treatment of the underlying disorder. In some cases, as in malignant disease, in vitamin D poisoning and after a failed parathyroidectomy, the hypercalcaemia itself needs to be treated. A large number of methods have been advocated for this, but phosphate is the drug of choice in most patients. This paper outlines its use, mode of action and side effects ...

Central nervous system disorders are not uncommon in patients with hyperparathyroidism and hypercalcaemia. Usually these consist of neuropsychiatric disturbances but acute encephalopathies and seizures may occur. A rare manifestation is cerebral infarction. A patient is presented with neuroradiological evidence of infarction caused by cerebral arterial spasm which appears related to hypercalcae...