![]() ![]() ![]() Hypercalcemic crisis is a life-threatening emergency. Many patients with primary hyperparathyroidism have a benign course and do not need surgery. It is essential to exclude other causes before considering parathyroid surgery, and patients should be referred for parathyroidectomy only if they meet certain criteria. Parathyroid hormone is suppressed in malignancy-associated hypercalcemia and elevated in primary hyperparathyroidism. An initial diagnostic work-up should include measurement of intact parathyroid hormone, and any medications that are likely to be causative should be discontinued. ![]() Some other important causes of hypercalcemia are medications and familial hypocalciuric hypercalcemia. The most common causes of hypercalcemia are primary hyper-parathyroidism and malignancy. Clinical manifestations affect the neuromuscular, gastrointestinal, renal, skeletal, and cardiovascular systems. The diagnosis often is made incidentally in asymptomatic patients. Hypercalcemia is a disorder commonly encountered by primary care physicians. ![]()
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