Approach to the Management of the Hypercalcemic Patient with Parathyroid Hormone-Dependent Hypercalcemia - Flowchart
Approach to the Management of the Hypercalcemic Patient with Parathyroid Hormone-Dependent Hypercalcemia - Flowchart Hypercalcemia-Clinical Algorithms Hypercalcemia-Clinical Algorithms
«Flowchart»

PTH-dependent hypercalcemia

PTH-dependent hypercalcemia

PTH-dependent hypercalcemia

PTH-dependent hypercalcemia

24-hr urine calcium and creatinine
Urine calcium <100 mg/day, or ClCa/ClCr <0.01

24-hr urine calcium and creatinine
Urine calcium <100 mg/day, or ClCa/ClCr <0.01

24-hr urine calcium and creatinine
Urine calcium <100 mg/day, or ClCa/ClCr <0.01

24-hr urine calcium and creatinine
Ca Cr

Yes

Yes

Yes Yes

No

No

No No

Presumptive FHH; consider family screening

Presumptive FHH; consider family screening

Presumptive FHH; consider family screening

Primary hyperparathyroidism

Primary hyperparathyroidism

Primary hyperparathyroidism

Age <40, or Fam. Hx.

Age <40, or Fam. Hx.

Age <40, or Fam. Hx.

Yes

Yes

Yes Yes

No

No

No No

Medical observation

Medical observation

Medical observation

End

End

End

Perform bone densitometry

Perform bone densitometry

Perform bone densitometry

<Next Node>

<Next Node>

<Next Node>

<Next Node>

Review criteria for surgery

Review criteria for surgery

Review criteria for surgery

Yes

Yes

Yes Yes

No

No

No No

PTH normal

PTH normal

PTH normal PTH normal

PTH high

PTH high

PTH high PTH high

Primary hyperparathyroidism

Primary hyperparathyroidism

Primary hyperparathyroidism

Li therapy

Li therapy

Li therapy

Li-induced hyperparathyroidism

Li-induced hyperparathyroidism

Li-induced hyperparathyroidism

Consider stopping Li therapy

Consider stopping Li therapy

Consider stopping Li therapy

Calcium high

Calcium high

Calcium high Calcium high

Calcium normal

Calcium normal

Calcium normal Calcium normal