nLkCALCALMIA

NUkDALILA SAnIDAN
4th LAk MLDICAL S1UDLN1
CCN1LN1S
ueflnlLlon and ConLrol of Calclum
Lpldemlology
Slgns and sympLoms
Causes
lnvesLlgaLlons
ManagemenL
CompllcaLlons
DLIINI1ICN AND CCN1kCL CI CALCIUM
LlevaLed calclum level ln Lhe blood
normal range for serum calclum ls 212263
mmol/L
araLhyrold hormone (1P)8one calclum and
phosphaLe reabsoprLlon kldney calclum buL
phosphaLe reabsorpLlon So serum calclum buL
serum phosphaLe
vlLamln u converLed Lo calclLrlol ln kldney
Lead Lo lncrease reabsorpLlon ln guL and kldney
CalclLonln ln plasma calclum and phosphaLe
LIDLMICLCG
n uncommon problem
ffecL 4 ln 100 000 populaLlon per year
lemale Male 31
eak age of lncldence of 3060 years old
SIGNS AND SM1CMS
eneral mnemonlc
8ones ( bone paln)
SLones ( kldney sLones)
roans ( consLlpaLlons)
sychlc moans ( faLlgue depresslon confuslon)
CLher sympLoms abdomlnal paln vomlLlng
polyurla polydlpsla anorexla weakness
hyperLenslon pyrexla renal fallure cardlac
arresL
CAUSLS
rlmary PyperparaLhyroldlsm
Ma||gnancy breasL lung myeloma bone meLasLases
Drugs vlL u lnLoxlcaLlon 1hlazlde vlL
Granu|omatous Sarcoldosls 1uberculosls
Lndocr|ne 1hyroLoxlcosls haeochromocyLoma
rlmary drenal lnsufflclenL
Iam|||a| lamlllal Pypocalclurlc Pypercalcaemla
Cthers dehydraLlon posLkldney LransplanL/chronlc
dlalysls prolonged lmmoblllsaLlon mllkalkall syndrome
luS
INVLS1IGA1ICNS
8lood LesLs calclum phosphaLe magneslum
creaLlnlne uL alk phos 1P
Cx8
C1 scan / M8l / lv
Mammogram
Low albumln low chlorlde and an alkalosls
suggesL mallgnancy
ShorL C1 lnLerval ln LC
MANAGLMLN1
lv lluld (09 sallne eg 46 L ln 24h as needed)
CorrecL elecLrolyLe lmbalance
ulureLlcs ( furosemlde 40 mg/12h C/lv vold
Lhlazlde)
1reaL underlylng cause
8lphosphonaLes lnhlblLs osLeoclasL Max effecL
ls aL 1 wk
SLerolds
CalclLonln (rarely used due Lo slde effecLs)
ChemoLherapy ln mallgnancy
CCMLICA1ICNS
(UN1kLA1LD SLVLkL nLkCALCLMIA)
CsLeoporosls
kldney sLones
kldney fallure
nervous sysLem dysfuncLlon
rrhyLhmla