Differential Diagnosis of Hypercalcaemia
Non malignant causes of hypercalcaemia include:
- Chronic renal failure
- Endocrine disorders (hyperthyroidism, phaeochromocytoma, Addison’s disease)
- Familial hypocalciuric hypercalcaemia
- Immobilisation
- Laboratory artifact due to altered albumin concentration or serum pH
- Medications (vitamin A toxicity [dietary fads, isotretinoin overdose, multivitamin overdose], oestrogens, antioestrogens, thiazides, lithium)
- Milk-alkali syndrome
- Primary hyperparathyroidism
- Vitamin D toxicity
- Granulomatous disease (sarcoidosis, tuberculosis)
Malignancies causing hypercalcaemia
|
Malignancy |
Frequency |
| Multiple myeloma | 40 to 50% |
| Breast | >20% |
| Lung | Usually squamous cell |
| Squamous cell cancers of head, neck, oesophagus and thyroid | Rarely |