Diagnostic des hypercalcémies « non hyperparathyroïdiennes »

Abstract

Hypercalcemia is a commonly encountered disorder and there are a great number of causes. Once hypercalcemia is established, the repercussion of this hypercalcemia found, and urgent treatment carried out if needed be, the search for an etiology must to be done, and this could be of variable difficulty. Two causes are frequent and account for about 90 % of all hypercalcemia cases: primary hyperparathyroidism (seen in an other chapter) and malignancy (cancer, multiple myeloma or other hemopathies). The responsibility of drug as the origin of the hypercalcemia must always be researched and can sometimes rapidly resolve this etiological diagnosis. Elsewhere, once the diagnosis of a primary hyperparathyroidism dismissed, the causes of hypercalcemia associated with a low rate of circulating parathormone must be searched for. Besides malignancy-associated hypercalcemia, with humoral hypercalcemia of malignancy or local osteolytic malignancy, the causes of hypercalcemia mediated by elevated levels of calcitriol, endocrine disorders, prolonged immobilization will be sought. In some cases, hypercalcemia is accompanied by symptoms leading to the diagnosis, elsewhere the search for the etiology is more complicated and a number of other rare conditions are important to consider.