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• #1 Etiology of hypercalcemia – UpToDate

  https://www.uptodate.com/contents/etiology-of-hypercalcemia

  Etiology of hypercalcemia […] Hypercalcemia is a relatively common clinical problem. It results when the entry of calcium into the circulation exceeds the excretion of calcium into the urine or deposition in bone. This occurs when there is accelerated bone resorption, excessive gastrointestinal absorption, or decreased renal excretion of calcium. Among all causes of hypercalcemia, primary hyperparathyroidism and malignancy are the most common, accounting for greater than 90 percent of cases. […] Primary hyperparathyroidism — Hypercalcemia in primary hyperparathyroidism is due to parathyroid hormone (PTH)-mediated osteoclast activation, leading to increased bone resorption. Elevated intestinal calcium absorption due to PTH-mediated increases in renal synthesis of 1,25-dihydroxyvitamin D is also important. Primary hyperparathyroidism is most often due to a parathyroid adenoma.

• #2 Hypercalcemia: A Review – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36282253/

  Hypercalcemia affects approximately 1% of the worldwide population. […] Approximately 90% of people with hypercalcemia have primary hyperparathyroidism (PHPT) or malignancy. Additional causes of hypercalcemia include granulomatous disease such as sarcoidosis, endocrinopathies such as thyroid disease, immobilization, genetic disorders, and medications such as thiazide diuretics and supplements such as calcium, vitamin D, or vitamin A. […] Hypercalcemia has been associated with sodium-glucose cotransporter 2 protein inhibitors, immune checkpoint inhibitors, denosumab discontinuation, SARS-CoV-2, ketogenic diets, and extreme exercise, but these account for less than 1% of causes. […] The underlying cause of hypercalcemia should be identified and treated.

• #3 Diagnostic approach to hypercalcemia – UpToDate

  https://www.uptodate.com/contents/diagnostic-approach-to-hypercalcemia

  Hypercalcemia is a relatively common clinical problem. Among all causes of hypercalcemia, primary hyperparathyroidism and malignancy are the most common, accounting for greater than 90 percent of cases. Therefore, the diagnostic approach to hypercalcemia typically involves distinguishing between the two. […] Although hypercalcemia in otherwise healthy outpatients is usually due to primary hyperparathyroidism and malignancy is more often responsible for hypercalcemia in hospitalized patients, other potential causes of hypercalcemia must be considered. […] This topic will review the diagnostic approach to hypercalcemia. The clinical manifestations, etiology, and treatment are reviewed separately. […] (See „Etiology of hypercalcemia”.)

• #4 10. Hypercalcemia | Hospital Handbook

  https://hospitalhandbook.ucsf.edu/content/10-hypercalcemia

  Almost always due to a combination of increased bone resorption/increased GI absorption and decreased renal excretion. […] 90% due to hyperparathyroidism or malignancy. If mild, more likely primary hyperparathyroidism; if moderate to severe, more likely malignancy-related. […] 10% due mostly to granulomatous disease, as well as some rare causes. […] 90% of hypercalcemia is due to hyperparathyroidism or malignancy.

• #5 Hypercalcemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/symptoms-causes/syc-20355523

  Hypercalcemia is a condition in which the calcium level in the blood becomes too high. […] Most often, hypercalcemia happens after one or more of the parathyroid glands make too much hormone. Other causes of hypercalcemia include cancer, certain other medical conditions and some medicines. Taking too much of calcium and vitamin D supplements also can cause hypercalcemia. […] Hypercalcemia can be caused by: Overactive parathyroid glands. This also is called hyperparathyroidism. It’s the most common cause of hypercalcemia. Overactive parathyroid glands make too much parathyroid hormone. The condition can stem from a small tumor that isn’t cancer. It also can stem from one or more of the four parathyroid glands becoming larger. […] Cancer. Lung cancer, breast cancer and some blood cancers can raise the risk of hypercalcemia. Cancer that spreads to the bones also raises the risk.

• #6 What Causes Hypercalcemia? Here Are 7 Known Causes

  https://www.webmd.com/a-to-z-guides/hypercalcemia-causes

  If your doctor tells you that you have hypercalcemia, it means you have too much calcium in your blood. The possible causes of high calcium levels include more than 25 diseases, as well as some medications, supplements, genes, and lifestyle factors. […] While high blood calcium levels have many potential causes, about 90% of cases are linked to two causes: problems with the parathyroid glands or cancer. […] The most common cause of high blood calcium levels is overactivity in one or more of these four glands, which sit behind your thyroid, in your neck. […] If hyperparathyroidism is the cause of your high calcium, you may also get: Depression, Memory loss, Heartburn, Sleep trouble, Bone and muscle pain, Fatigue. […] About 10%-30% of people with cancer may get hypercalcemia. That’s because cancer can: Cause your bones to break down and send calcium into your blood, Mimic your parathyroid hormone, which triggers the release of calcium from your bones, Affect your kidneys, which can lower the amount of calcium expelled when you pee.

• #7 Hypercalcemia: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000365.htm

  Hypercalcemia means you have too much calcium in your blood. […] The most common cause of high calcium blood level is excess PTH released by the parathyroid glands. This excess occurs due to: […] Calcium blood level may also be high if your body is low on fluids or water. […] Other conditions can also cause hypercalcemia: […] Men and women of all ages can have a high blood calcium level. However, it is most common in women over age 50 (after menopause). In most cases, this is due to an overactive parathyroid gland.

• #8 Incidence, etiology, and course of hypercalcemia-induced AKI in a tertiary care center from northern India | The Egyptian Journal of Internal Medicine | Full Text

  https://ejim.springeropen.com/articles/10.1186/s43162-021-00067-8

  Hypercalcemia is known to cause acute kidney injury (AKI). […] Hypercalcemia is a relatively common clinically presenting problem with 90% of all cases accounted for by primary hyperparathyroidism and malignancy. […] Causes of PTH-mediated hypercalcemia include primary hyperparathyroidism, familial hypocalciuric hypercalcemia, and ectopic PTH secretion. Causes of non-PTH-mediated hypercalcemia comprise vitamin D-mediated hypercalcemia (vitamin D intoxication, lymphoma, granulomatous diseases), vitamin A intoxication, hyperthyroidism, drug-induced hypercalcemia (hydrochlorothiazide, theophylline, and lithium), immobilization, milk-alkali syndrome, adrenal insufficiency, and humoral hypercalcemia of malignancy. […] Primary hyperparathyroidism is the most common cause of hypercalcemia in the community. It is caused by a single adenoma in about 85% of cases, with hyperplasia of all four parathyroids in 10% to 15% and with carcinoma in less than 2%.

• #9 Hyperparathyroidism

  https://www.nhs.uk/conditions/hyperparathyroidism/

  In 4 out of 5 cases, primary hyperparathyroidism is caused by a non-cancerous tumour called an adenoma on one of the parathyroid glands. […] Less commonly, it can occur if 2 or more parathyroid glands become enlarged (hyperplasia). […] Very rarely, primary hyperparathyroidism can be caused by cancer of a parathyroid gland. […] Treatment for secondary hyperparathyroidism depends on the underlying cause. […] Low vitamin D is the most common cause and can be corrected with oral vitamin D (colecalciferol). […] Another common cause is kidney disease.

• #10 Etiology of hypercalcemia – UpToDate

  https://www.uptodate.com/contents/etiology-of-hypercalcemia

  Tertiary hyperparathyroidism — Patients with severe chronic kidney disease often develop frankly low or low-normal serum calcium concentrations due to decreased renal synthesis of 1,25-dihydroxyvitamin D. Prolonged chronic hypocalcemia causes compensatory increases in serum PTH (secondary hyperparathyroidism) and leads to parathyroid gland hyperplasia over time.

• #11 Hypercalcemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia

  Secondary hyperparathyroidism occurs most commonly in advanced chronic kidney disease when decreased formation of active vitamin D in the kidneys and other factors lead to hypocalcemia and chronic stimulation of PTH secretion. […] Tertiary hyperparathyroidism results in autonomous hypersecretion of PTH regardless of serum calcium concentration.

• #12 Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430714/

  The etiology of hypercalcemia can be divided into 2 major categories: parathyroid hormonemediated and non-parathyroid hormonemediated. […] Primary hyperparathyroidism: This condition results in elevated levels of calcium with high or inappropriately normal parathyroid hormone levels and is typically caused by a parathyroid adenoma. […] Tertiary hyperparathyroidism: This condition also results in elevated levels of calcium and high levels of parathyroid hormone but is due to parathyroid hyperplasia from chronic overstimulation, most often in patients with renal failure or a history of renal transplant. […] Familial hypocalciuric hypercalcemia: This condition is caused by a loss-of-function mutation in the calcium-sensing receptor gene and is inherited in an autosomal dominant manner. […] Medications can also cause hypercalcemia. Lithium use leads to hypercalcemia by altering the set point at which calcium suppresses parathyroid hormone, requiring higher levels of calcium for parathyroid hormone suppression.

• #13 Hypercalcemia: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/240681-overview

  Approximately 90% of cases of hypercalcemia are caused by hyperparathyroidism or malignancy. […] About 20-30% of patients with cancer have hypercalcemia during the course of the disease, and its occurrence may signify an unfavorable prognosis. […] Of the cases that result from malignancy, approximately 80% are due to the effects of parathyroid hormone-related peptide (PTHrP), while the other 20% are due to bony metastases. […] Hypercalcemia secondary to malignancy may be classified into the following four types, based on the mechanism involved: Humoral hypercalcemia of malignancy (HHCM) from an increased secretion of PTHrP – Most common form, accounting for up to 80% of cases; Osteolytic hypercalcemia from osteoclastic activity and bone resorption surrounding the tumor tissue – The second most common mechanism, accounting for about 20% of cases; Secretion of active vitamin D by some lymphomas; Ectopic parathyroid hormone (PTH) secretion – Very rare.

• #14 Hypercalcemia | MedLink Neurology

  https://www.medlink.com/articles/hypercalcemia

  Primary hyperparathyroidism and malignancy-associated hypercalcemia are the most common causes of hypercalcemia, together accounting for more than 90% of cases. […] Hypercalcemia in the setting of malignancy is a common oncologic emergency and develops in 20% to 30% of patients with cancer. […] Hyperparathyroidism is the most common cause of hypercalcemia and is most often identified in postmenopausal women with hypercalcemia and parathyroid hormone (PTH) levels that are either elevated or inappropriately normal. […] Malignancy-associated hypercalcemia is the most common cause of non-parathyroid hypercalcemia. […] Malignancy-associated hypercalcemia is a common complication, occurring in 10% to 30% of patients with cancer. […] Production of humoral factors by the primary tumor is collectively known as humoral hypercalcemia of malignancy and is the mechanism responsible for 80% of cases of malignancy-associated hypercalcemia.

• #15 Hypercalcemia in Cancer: Causes, Effects, and Treatment Strategies

  https://www.mdpi.com/2073-4409/13/12/1051

  When discussing the causes of HCM, we can distinguish four basic mechanisms leading to an increase in calcium concentration in the blood. The most common form (approximately 80% of all cases) is humoral hypercalcemia caused by the production of parathyroid hormone-related peptide (PTHrP). The next most frequent cause is bone metastases (osteolytic hypercalcemia), which account for approximately 20% of hypercalcemia in cancer. Excessive production and activation of extrarenal 1,25-dihydroxyvitamin D is responsible for 1% of cases, while the rarest cause, accounting for less than 1% of all cancer-related hypercalcemia, is ectopic secretion of parathyroid hormone. Generally, hypercalcemia in cancer is most often caused by increased bone resorption and insufficient ability of the kidneys to eliminate excess amounts of calcium.

• #16 Hypercalcemia of Malignancy | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/hypercalcemia-of-malignancy

  People with high blood calcium, also called hypercalcemia, have above-normal levels of calcium in their blood. The most common cause of high blood calcium is a condition called primary hyperparathyroidism, or PHPT. […] Hormone problems are some of the many possible causes of high blood calcium. Certain types of cancer can also cause high blood calcium. This usually occurs late in the course of the cancer and is referred to as hypercalcemia of malignancy (HCM). HCM is estimated to affect between 2% to 30% of patients with cancer, rates that vary depending on cancer type and disease stage. […] HCM causes can split into different categories, including: Humoral hypercalcemia of malignancy (HHM) is caused by too much parathyroid hormone-related peptide (PTHrP) from malignant tumors. Local osteolytic hypercalcemia (LOH) is caused by decreased mobility or cancer that attacks the bone, which will cause high blood calcium levels. Hypercalcemia due to multiple myeloma happens through a combination of different factors, including LOH from tumors in the bone, along with injury to the kidneys that prevents them from urinating out the excess calcium. Calcitriol-mediated hypercalcemia, also called Vitamin D 1,25-mediated hypercalcemia, is caused by the increased conversion of inactive vitamin D to the active form of vitamin D (calcitriol). This is seen in diseases such as lymphoma, sarcoidosis, and other granulomatous diseases. Too much calcitriol can lead to high blood calcium levels.

• #17 Hypercalcemia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14597-hypercalcemia

  Hypercalcemia happens when you have higher-than-normal levels of calcium in your blood. It’s usually caused by primary hyperparathyroidism or certain cancers and is treatable with surgery and/or medication. […] More than 25 separate diseases, several medications and even dehydration can cause hypercalcemia. Primary hyperparathyroidism and various kinds of cancers account for the greatest percentage of all people with hypercalcemia. […] In primary hyperparathyroidism, one or more of your four parathyroid glands produce too much parathyroid hormone the hormone responsible for controlling blood calcium levels. […] About 2% of all cancers are associated with hypercalcemia, and cancer-related hypercalcemia cases (also called hypercalcemia of malignancy) often have a rapid onset and are severe. Certain types of cancer that can cause hypercalcemia include: Lung cancer, Breast cancer, Multiple myeloma (cancer that forms in a type of white blood cell), Renal cell carcinoma (a type of kidney cancer), Certain cancers of the blood (leukemia), Lymphoma (cancer of the lymphatic system), Rhabdomyosarcoma (muscle cell cancer).

• #18 Hypercalcemia: Cancer-Related Causes & Treatment

  https://www.cancercenter.com/integrative-care/hypercalcemia

  When you have cancer, one of the side effects may be hypercalcemia, indicated by too much calcium in the blood. […] Cancer is one of the two main causes of hypercalcemia, the other being hyperparathyroidism, which is when the parathyroid glands in your neck secrete too much hormone. […] There are three main causes of cancer-related hypercalcemia: […] Extreme levels of parathyroid hormone-related protein (PTHrP) are responsible for about 80 percent of cases, according to StatPearls. […] Cancers that have spread to bone, or metastasized, account for about 20 percent of cases, according to StatPearls. […] Increased production of 1,25-dihydroxyvitamin D triggers hypercalcemia in most Hodgkin lymphoma cases and roughly a third of non-Hodgkin lymphoma cases.

• #19 Hypercalcemia: What Is It, Symptoms, Causes and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/hypercalcemia

  Hypercalcemia is a state of high calcium levels in your blood. Primary hyperparathyroidism, vitamin D toxicity, certain cancers, diseases, and medications can cause the condition. […] The causes of hypercalcemia are certain medications, diseases, and dehydration. However, the primary causes are primary hyperparathyroidism and hypercalcemia of malignancy. […] Primary hyperparathyroidism: Our body has four parathyroid glands behind the thyroid gland in the neck. They work with the bones, kidneys, and intestines to maintain the level of blood calcium. When one or more parathyroid glands become overactive, they produce and release an excess of parathyroid hormone, elevating blood calcium levels. […] Malignancy-induced hypercalcemia Approximately 2% of all cancers may result in hypercalcemia. The hypercalcemia of malignancy typically occurs suddenly and is severe. Breast cancer, lung cancer, multiple myeloma, renal cell carcinoma, leukemia, lymphoma, and rhabdomyosarcoma are cancers that can induce this condition.

• #20 Hypercalcemia: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/240681-overview

  The remaining 10% of cases of hypercalcemia are caused by many different conditions, including vitamin D-related problems; disorders associated with rapid bone turnover; and, in rare cases, familial disorders. […] Causes of hypercalcemia that are related to malignancy (most commonly, lung cancer, breast cancer, and myeloma) include the following: Solid tumor metastases; Solid tumors with humoral effects; Hematologic malignancies. […] Causes of hypercalcemia that are related to the parathyroid include the following: Primary hyperparathyroidism – Solitary adenoma, generalized hyperplasia, multiple endocrine neoplasia type 1 or type 2A; Lithium-related release of PTH; Familial high PTH levels; Neonatal severe hyperparathyroidism; Kidney transplantation. […] Causes related to vitamin D include the following: Vitamin D toxicity; Granulomatous disease (especially sarcoidosis).

• #21 Hypercalcemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia

  Hypercalcemia usually results from excessive bone resorption. There are many causes of hypercalcemia, but the most common are hyperparathyroidism and cancer. […] Principal causes include hyperparathyroidism, vitamin D toxicity, and cancer. […] Cancer is a common cause of hypercalcemia, usually in hospitalized patients. Although there are several mechanisms, elevated serum calcium ultimately occurs as a result of bone resorption. […] Vitamin D toxicity can be caused by high concentrations of endogenous 1,25(OH)2D. […] Granulomatous disorders, such as sarcoidosis, tuberculosis, leprosy, berylliosis, histoplasmosis, and coccidioidomycosis, lead to hypercalcemia and hypercalciuria. […] Immobilization, particularly complete prolonged bed rest in patients at risk, can result in hypercalcemia due to accelerated bone resorption.

• #22 Disease Management: Hypercalcemia

  https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/hypercalcemia/default.htm

  The predominant mechanism for the development of hypercalcemia and hypercalciuria in granulomatous diseases is increased intestinal absorption of calcium induced by elevated calcitriol levels. […] Familial hypocalciuric hypercalcemia (FHH) is a rare condition caused by an inactivating disorder of calcium-sensing receptors. […] Vitamin D intoxication can cause hypercalcemia because of increased intestinal calcium absorption and increased bone resorption. […] Thiazide diuretics can result in hypercalcemia in patients with increased bone resorption. […] Hypercalcemia of acute renal failure occurs mainly in patients with rhabdomyolysis.

• #23 Hypercalcemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430714/

  Thiazide diuretics increase calcium reabsorption in the distal convoluted tubule of the nephron, resulting in parathyroid hormone-independent hypercalcemia. […] Hypercalcemia of malignancy: This condition is most commonly caused by excessive production of parathyroid hormonerelated protein by tumors, which act on parathyroid hormone receptors due to their structural similarity. […] Vitamin D toxicity: In addition to 1,25-dihydroxy vitamin D, increased levels of 25-hydroxy vitamin D are also a major cause of hypercalcemia. […] Endocrinopathies: Patients with hyperthyroidism often have increased osteoclast activity and bone resorption, leading to increased levels of both total and ionized calcium. […] Hypercalcemia of immobilization: Although uncommon, this is an important etiology, especially in patients with limited mobility. […] Other rare etiologies of hypercalcemia are showcased in case reports.

• #24 What Causes Hypercalcemia? Here Are 7 Known Causes

  https://www.webmd.com/a-to-z-guides/hypercalcemia-causes

  The third most common cause of high blood calcium levels is the overuse of calcium carbonate, which many people take as both a calcium supplement and an antacid, to treat heartburn and indigestion. […] Vitamin D helps regulate levels of calcium in your body. If you take extremely high doses of vitamin D, you may end up with very high levels of calcium in your blood. […] Excess vitamin A can also result in high calcium levels. […] Medications that might cause or worsen high calcium levels include: Blood pressure drugs, such as thiazide diuretics, which can lower the amount of calcium that leaves your body when you pee, Lithium, which might affect your parathyroid glands and the amount of PTH they make. […] If you inherit a certain gene, your body misjudges how much calcium is in your blood. You’ll send out more PTH than you need. It happens if you have a condition called familial hypocalciuric hypercalcemia (FHH).

• #25 Hypercalcemia: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/hypercalcemia

  Some medications, particularly diuretics, can produce hypercalcemia. […] Taking too much vitamin D or calcium in the form of supplements can raise your calcium level. […] High doses of these over-the-counter products are the third most common cause of hypercalcemia in the United States. […] Dehydration causes your calcium level to rise due to the low amount of fluid you have in your blood.

• #26 Hypercalcemia: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/240681-overview

  Causes related to high bone turnover include the following: Hyperthyroidism; Immobilization (especially in Paget disease); Thiazide diuretic use; Vitamin A intoxication; Kidney failure (milk-alkali syndrome). […] Other causes related to particular mechanisms are as follows: Increased intestinal calcium absorption; Idiopathic infantile hypercalcemia (Williams syndrome); Granulomatous disorders (eg, sarcoidosis); Decreased renal calcium excretion; Familial hypocalciuric hypercalcemia; Increased bone resorption; Mutations of the calcium-sensing receptor; Familial benign hypocalciuric hypercalcemia; Hypophosphatasia; Subcutaneous fat necrosis; Blue diaper syndrome; Dietary phosphate deficiency; Tuberculosis.

• #27 Hypercalcemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia

  Idiopathic infantile hypercalcemia is an extremely rare sporadic disorder with dysmorphic facial features, cardiovascular abnormalities, renovascular hypertension, and hypercalcemia. […] In milk-alkali syndrome, excessive amounts of calcium and absorbable alkali are ingested, usually during self-treatment with calcium carbonate antacids for dyspepsia or to prevent osteoporosis, resulting in hypercalcemia, metabolic alkalosis, and renal insufficiency. […] Hyperparathyroidism is a generalized disorder resulting from excessive secretion of parathyroid hormone (PTH) by one or more parathyroid glands. […] Familial hypocalciuric hypercalcemia involves an inactivating mutation of the calcium-sensing receptor gene, resulting in higher concentrations of serum calcium being needed to inhibit PTH secretion.

• #28 14 Causes of Hypercalcemia (High Blood Calcium) – SelfDecode Labs

  https://labs.selfdecode.com/blog/hypercalcemia/

  An overactive thyroid (hyperthyroidism) can cause hypercalcemia too. […] Prolonged immobilization can result in hypercalcemia and osteoporosis. […] Addison’s disease, also known as adrenal insufficiency, is another cause of hypercalcemia. […] Hypercalcemia is a complication of sarcoidosis, an inflammatory disease that attacks several organs in the body. […] Taking too much calcium is uncommon but possible. […] Genetics (certain mutations in your genes) can also be responsible for high blood calcium levels.

• #29 Hypercalcaemia: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/hypercalcaemia

  Hypercalcaemia causes (aetiology) […] Causes of hypercalcaemia may be grouped into those secondary to raised PTH levels and those mediated by other factors. Primary hyperparathyroidism and malignancy are responsible for greater than 90% of all cases. […] PTH-mediated hypercalcaemia […] Primary hyperparathyroidism is the most common cause of raised calcium levels, usually producing a mild hypercalcaemia. […] Non-PTH-mediated hypercalcaemia […] Malignancy – the most common cause of non-PTH-mediated hypercalcaemia. […] Granulomatous conditions – eg, sarcoidosis and tuberculosis. […] Endocrine conditions – eg, thyrotoxicosis, phaeochromocytoma and primary adrenal insufficiency. […] Drugs – eg, thiazide diuretics, vitamin D and vitamin A supplements. […] Familial – eg, familial hypocalciuric hypercalcaemia.

• #30 Hypercalcemia in Dogs and Cats – Endocrine System – Merck Veterinary Manual

  https://www.merckvetmanual.com/endocrine-system/the-parathyroid-glands-and-disorders-of-calcium-regulation-in-dogs-and-cats/hypercalcemia-in-dogs-and-cats

  Patients suffering from dehydration and renal insufficiency may develop hypercalcemia faster and become sicker due to the decreased renal calcium excretion. […] Hypercalcemia may occur in up to ~30% of patients with hypoadrenocorticism, or Addison disease; however, it is usually transient and resolves when the patient is treated with volume re-expansion, steroids, and, if needed, mineralocorticoids. […] Secondary hyperparathyroidism (SHPT) is characterized by increased PTH concentrations and low or normal calcium. […] Nutritional secondary hyperparathyroidism occurs with vitamin D deficiency and in patients fed diets with no or low calcium. […] Tertiary hyperparathyroidism (THPT) is a condition reflecting the development of abnormal parathyroid function after a period of secondary hyperparathyroidism, resulting in increased concentrations of PTH and ionized calcium.

• #31 Hypercalcemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypercalcemia/symptoms-causes/syc-20355523

  Other diseases. Conditions such as tuberculosis and sarcoidosis can raise blood levels of vitamin D. That in turn spurs the digestive tract to absorb more calcium. […] Genetic factors. A rare genetic condition called familial hypocalciuric hypercalcemia causes an increase of calcium in the blood. This condition doesn’t cause symptoms or complications of hypercalcemia. […] Little or no movement. People who have a condition that causes them to spend a lot of time sitting or lying down can get hypercalcemia. Over time, bones that don’t bear weight release calcium into the blood. […] Serious dehydration. This is a common cause of mild or short-term hypercalcemia. Having less fluid in the blood causes a rise in calcium. […] Some medicines. Medicines such as lithium and thiazide diuretics might cause more parathyroid hormone to be released. […] Supplements. Taking too much calcium or vitamin D supplements over time can raise calcium levels in the blood.

• #32 What Causes Hypercalcemia? | Orlando | UCF Health

  https://ucfhealth.com/our-services/endocrinology/what-causes-hypercalcemia/

  Hypercalcemia is a common clinical condition that can lead to chronic, moderate or mild levels of calcium in the blood. Many cases of hypercalcemia are caused by hyperparathyroidism (HPT) or malignancy. […] Hyperparathyroidism is a generalized disorder that happens when the thyroid glands secrete too much parathyroid hormone. Its the most common cause of hypercalcemia. Other causes of hypercalcemia can be: […] Primary hyperparathyroidism is one of the main causes of hypercalcemia and can be caused by issues within the endocrine system such as autoimmune disorders. […] In many instances, patients hospitalized for cancer can develop hypercalcemia. Breast cancer, ovarian cancer or renal cancer are some of the more common types of cancer that can cause hypercalcemia. […] This very rare sporadic disorder often causes dysmorphic facial features, heart abnormalities and hypercalcemia.

• #33 Hypercalcemia: Symptoms, Causes, and Treatments

  https://resources.healthgrades.com/right-care/endocrinology-and-metabolism/hypercalcemia

  Hypercalcemia occurs when the body cannot regulate and eliminate calcium properly. Two main causes of hypercalcemia are primary hyperparathyroidism and malignancy, or cancer. They account for 90% of hypercalcemia cases. […] Primary hyperparathyroidism causes one or more enlarged parathyroid glands to release excess parathyroid hormone. This can affect the systems that control how much calcium is in the blood. […] If cancer has spread to the bones, this can result in the release of calcium. This may occur due to renal carcinomas, leukemia, lymphoma, rhabdomyosarcoma, multiple myeloma, lung cancer, or breast cancer. Around 30% of people with cancerous cells or cancer experience hypercalcemia. […] Other causes of hypercalcemia include: hypervitaminosis D, or vitamin D toxicity; excessive milk intake; granulomatous conditions, such as sarcoidosis, tuberculosis, and fungal infections; endocrine conditions, such as thyrotoxicosis, hypoadrenalism, and pheochromocytomas; Williams syndrome; hypophosphatasia; hypervitaminosis A; milk-alkali syndrome; subcutaneous fat necrosis; acute or chronic renal failure; and using thiazide diuretics or lithium.

• #34 Hypercalcemia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14597-hypercalcemia

  Common medications and supplements that can cause hypercalcemia include: Hydrochlorothiazide and other thiazide diuretics (prescribed for high blood pressure and edema), Lithium, Excessive intake of vitamin D, vitamin A or calcium supplements. […] Other less common causes of hypercalcemia include: Lung diseases such as sarcoidosis and tuberculosis, Kidney failure, Thyrotoxicosis, Being bedridden/immobilized for a prolonged time, Pagets disease of the bone.

• #35

  https://step1.medbullets.com/endocrine/109023/hypercalcemia

  An increase in serum calcium level […] dietary causes […] calcium ingestion (milk-alkali syndrome) […] hypervitaminosis D […] hypervitaminosis A […] pharmacologic causes […] thiazides […] causes increased distal tubule reabsorption of calcium […] used to treat hypercalciuria […] malignancy-associated causes […] Paget’s disease […] can be come hypercalcemic if patient is immobilized […] squamous cell cancer of the lung […] ectopic production of PTH (PTH related peptide – PTHrP) […] multiple myeloma […] production of IL-1 activates osteoclast-driven bone resorption […] sarcoidosis […] granulomatous macrophages produce 1-hydroxylase which produces high amounts of 1,25 vitamin D […] hyperparathyroid […] genetic causes […] familial hypocalciuric hypercalcemia

• #36 Hypercalcemia: A Practice Overview of Its Diagnosis and Causes

  https://www.mdpi.com/2673-8236/5/1/7

  Hypercalcemia is defined as a serum calcium concentration higher than 10.5 mg/gL or 2.6 mmol/L. […] Many variables can lead to hypercalcemia, and managing them is necessary to treat this ion disorder. Indeed, it can be caused by malignancies, hematologic disorders, or genetic diseases such as familial hypocalciuric hypercalcemia, or it can be related to hormone disorders involving parathormone or vitamin D. […] The causes of hypercalcemia can be split into two groups: PTH-mediated hypercalcemia with normal–high PTH and Non-PTH-mediated hypercalcemia with low PTH. […] PTH-mediated hypercalcemia includes primary hyperparathyroidism (HPT), tertiary HPT, familial hypocalciuric hypercalcemia (FHH), and lithium-related adverse events. […] Non-PTH-mediated hypercalcemia includes hypercalcemia caused by the overproduction of PTH-related peptide (PTHrP), a higher vitamin D concentration, malignancies, milk-alkali syndrome, and William’s syndrome. […] Hypercalcemia is often reported in some infectious diseases or as an adverse event in patients who use antimicrobic agents.

• #37 Hypercalcemia in Cancer: Causes, Effects, and Treatment Strategies

  https://www.mdpi.com/2073-4409/13/12/1051

  A noteworthy fact is that metastatic breast cancer cells can additionally produce PTHrP locally, without significant changes in serum PTHrP concentrations. This type of hypercalcemia occurs primarily in multiple myeloma, breast cancer, and (much less frequently) in leukemias and lymphomas. The mechanism underlying osteolytic hypercalcemia is indirect bone destruction by metastatic cancer cells that produce substances that influence the formation of osteoclasts.

• #38 Hypercalcemia Causes, Symptoms, and Treatments

  https://www.upmc.com/services/kidney-disease/conditions/hypercalcemia

  Hypercalcemia also known as high calcium levels happens when you have too much calcium in your blood. Although there are many causes for hypercalcemia, it can happen when you have a parathyroid disorder, a genetic condition, or your kidneys arent working properly. […] Many factors can cause or contribute to hypercalcemia, including: Cancers such as breast cancer, leukemia, lung cancer, lymphoma, multiple myeloma, muscle cell cancer, and renal cell carcinoma. Genetic conditions that affect your bodys calcium levels. Kidney failure or chronic kidney disease. Lung diseases, such as sarcoidosis or tuberculosis. Medications, such as diuretics (water pills), lithium, or dietary supplements containing vitamin D, vitamin A, or calcium. Parathyroid disorders that affect hormone levels, such as hyperparathyroidism. […] You may be at risk for hypercalcemia if you: Have a parathyroid disorder. Have cancer, kidney disease, or lung disease. Have a genetic condition that causes problems with calcium levels. Take medications, including supplements, that raise your calcium levels.

• #39 Hypercalcaemia | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/hypercalcaemia/

  Hypercalcaemia is the presence of abnormally high calcium levels in the blood. […] What causes hypercalcaemia? […] Calcium metabolism is affected by three hormones. They are parathyroid hormone, vitamin D and calcitonin (which only has a minor effect). Parathyroid hormone and vitamin D increase circulating calcium, whereas calcitonin acts to reduce it. […] Hypercalcaemia has several common causes, including: Enlargement or adenoma on one or more of the four parathyroid glands, causing it (them) to secrete an increased amount of parathyroid hormone. […] An association with various cancers: cancers of lung and kidney can cause high calcium levels by producing a hormone similar to parathyroid hormone, known as parathyroid hormone related peptide (PTHrp) […] Rarer causes of hypercalcaemia include: Excess intake of vitamin A and/or vitamin D. […] An overactive thyroid gland (hyperthyroidism) or kidney failure. […] Hypercalcaemia as a result of hyperparathyroidism can be inherited as part of multiple endocrine neoplasia type 1 syndrome as well as other rare inherited conditions.

• #40 Hypercalcemia in Cancer: Causes, Symptoms, and Management – Cancer Therapy Advisor

  https://www.cancertherapyadvisor.com/features/hypercalcemia-in-cancer-causes-symptoms-and-management/

  Hypercalcemia affects up to 30% of patients with cancer. It has been seen in most cancers but is most common in patients with non-small cell lung cancer, breast cancer, multiple myeloma, head and neck squamous cell carcinoma, urothelial cancer, and ovarian cancer. Hypercalcemia seen in cancer patients may have underlying nonmalignant causes, as well as cancer-mediated etiologies, said Raquel E. Reinbolt, MD, of The Ohio State University Comprehensive Cancer Center in Columbus. Some of the nonmalignant causes of hypercalcemia that may be seen in cancer patients are similar to those found in the general population, she added. […] Cancer-associated hypercalcemia has been classified into 4 subtypes: humoral, local osteolytic, 1,25-dihydroxyvitamin D-mediated, and ectopic hyper-parathyroidism. Humoral hypercalcemia of malignancy is typically caused by tumor secretion of parathyroid hormone-related protein (PTHrP). This increases osteoclastic bone resorption and renal tubular reabsorption of calcium by binding the parathyroid hormone (PTH)-PTHrP type 1 receptor in the bones and kidneys. Local osteolytic hypercalcemia, which is characterized by extensive bone metastasis, is due to tumor cells in bone producing cytokines that increase osteoclastic bone resorption and suppress osteoblastic bone formation. With ectopic hyperparathyroidism, tumors produce parathyroid hormone (PTH), which can act alone or in concert with PTHrP to stimulate bone resorption. With hypercalcemia mediated by excess production of 1,25-dihydroxyvitamin D, tumors upregulate the expression of Cyp27B1, which encodes 1-alpha-hydroxylase, the enzyme that converts 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D. Excess 1,25-dihydroxyvitamin D increases intestinal calcium absorption and bone resorption. […] Determining the mechanism of hypercalcemia is important to ensure that the best management approach is undertaken, and the severity of hypercalcemia may also impact the therapies chosen, Dr Reinbolt noted.

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