Alteraciones del metabolismo fosfocálcico. Hipercalcemia. Hiperparatiroidismo

Abstract

IntroductionHypercalcaemia is a relatively common disorder. Ninety percent of hypercalcaemia cases take place in the context of primary hyperparathyroidism (PHP) and tumour-induced hypercalcaemia. SymptomsA considerable variety of symptoms affecting several organs and systems have been described, including the specific manifestations of PHP (nephrolithiasis and osteitis fibrosa cystica), although the most common manifestation is asymptomatic PHP. DiagnosisThe first test to request for the aetiological diagnosis of hypercalcaemia should be the parathyroid hormone (PTH) measurement, followed by the measurement of phosphorus, vitamin D and 24-h urine levels to determine calciuria and creatinine clearance. TreatmentThe most important measure in treating severe hypercalcaemia is rehydration, followed by treatment with intravenous zoledronate to subsequently resolve the underlying cause. For PHP, the only curative treatment is parathyroidectomy.