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Table 176-1

Classification of Causes of Hypercalcemia

  1. Parathyroid-related
    1. Primary hyperparathyroidism
      1. Solitary adenomas or rarely carcinoma
      2. Multiple endocrine neoplasia
    2. Lithium therapy
    3. Familial hypocalciuric hypercalcemia
  2. Malignancy-related
    1. Solid tumor with humoral mediation of hypercalcemia (lung, kidney, squamous cell carcinoma)
    2. Solid tumor with metastases (breast)
    3. Hematologic malignancies (multiple myeloma, lymphoma, leukemia)
  3. Vitamin D-related
    1. Vitamin D intoxication
    2. ↑1,25(OH)2D; sarcoidosis and other granulomatous diseases
    3. ↑1,25(OH)2D; impaired 1,25(OH)2D metabolism due to 24-hydroxylase deficiency
  4. Associated with high bone turnover
    1. Hyperthyroidism
    2. Immobilization
    3. Thiazides
    4. Vitamin A intoxication
    5. Fat necrosis
  5. Associated with renal failure
    1. Severe secondary or tertiary hyperparathyroidism
    2. Aluminum intoxication
    3. Milk-alkali syndrome