Hypercalcemia (cont.)
How is hypercalcemia diagnosed?
Hypercalcemia is easily diagnosed with a blood test.
Diagnosing the causes of hypercalcemia, however, is a more involved process; in
addition to a detailed history and physical examination, it may require further blood
tests (such as a PTH level and vitamin D level),
urine evaluation, X-rays, and other imaging
procedures.
How is hypercalcemia treated?
The treatment of elevated levels of calcium in the blood involves the
evaluation of the following:
- Is the level of calcium elevated enough to be dangerous, or is it causing
symptoms?
- What is the underlying cause of the hypercalcemia, and does it need
treatment?
If the hypercalcemia is causing severe symptoms, or if the
values are critically high, lowering the blood levels may require
hospitalization and the use of hydration, steroids, or even
dialysis. There are
intravenous medications
that can be used to lower calcium as well.
If the hypercalcemia is modest, treatment with medications can be
administered
on an outpatient basis.
If the underlying cause is hyperparathyroidism
(particularly from an adenoma), there are certain criteria that are reviewed to
discuss if surgery should be considered. These criteria include the absolute calcium
level, a history of kidney stones or other calcium-related complications, and
the amount of calcium seen in a 24-hour urine collection. Based on these
findings, surgical removal of the adenoma may be considered.
What is the prognosis for hypercalcemia?
The results of treatment for hypercalcemia depend on the underlying cause of the
condition. If hypercalcemia is seen in the presence of cancer, the average
one year survival rate is less than 30%. The prognosis
is excellent for many of the other
causes of hypercalcemia provided the underlying cause is addressed
and treated.
Next: Can hypercalcemia be prevented? »
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