The Curbsiders Internal Medicine Podcast #281 Hypercalcemia: Calci-fun! with Dr. Carl Pallais
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Jun 28, 2021 Dr. Carl Pallais discusses the management of hypercalcemia in this entertaining podcast. Topics covered include the importance of assessing lab results for calcium levels, interpreting calcium levels in the ambulatory setting, causes and effects of hypercalcemia, and the treatment of hypercalcemia including the use of medications and specific therapies. Stay tuned for interesting insights!
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Primary Hyperparathyroidism Is Common
- Primary hyperparathyroidism is the most common cause of hypercalcemia in ambulatory patients, especially postmenopausal women.
- Expect many cases to be mild and incidentally discovered on routine labs.
Adjust Calcium For Albumin
- Correct total calcium for albumin using ~0.8 mg/dL per 1 g/dL albumin drop to estimate ionized calcium.
- Avoid outpatient ionized calcium unless the sample is handled on ice and processed rapidly.
Lithium Alters Calcium Sensing
- Lithium raises calcium by ~0.5 mg/dL through a PTH-mediated alteration of the calcium-sensing receptor.
- Lithium can mimic familial hypocalciuric hypercalcemia physiology by resetting the sensor.