Hypercalcaemia - presentation and management

Clin Med (Lond). 2017 Jun;17(3):270-273. doi: 10.7861/clinmedicine.17-3-270.


Hypercalcaemia is a common disorder normally caused by primary hyperparathyroidism (PHPT) or malignancy. A proportion of cases present as an emergency, which carries a significant mortality. Emergency management of hypercalcaemia is based on intravenous rehydration with normal saline but when this is inadequate, bisphosphonate therapy is used; more recently the novel anti-resorbtive agent denosumab has been shown to have a useful role in treatment. It is estimated that up to 10% of all cases of PHPT presenting under the age of 45 years have an underlying genetic predisposition; nine potentially causative genes are now recognised and may be screened in routine clinical practice. Although parathyroidectomy is the only curative treatment for PHPT, this is indicated in a minority of cases. Many cases can be adequately managed conservatively and guidance from the 4th international workshop on the management of asymptomatic PHPT has recently been updated in a consensus statement.

Publication types

  • Review

MeSH terms

  • Diphosphonates / therapeutic use
  • Humans
  • Hypercalcemia* / diagnosis
  • Hypercalcemia* / physiopathology
  • Hypercalcemia* / therapy
  • Hyperparathyroidism, Primary
  • Parathyroidectomy


  • Diphosphonates