Classification of causes of hypercalcemia


causes of hypercalcemia

What are Parathyroid glands?

There are four parathyroid glands in our body. They are small pea-size behind the thyroid gland or thyroid cartilage. These glands are endocrine glands and take a role in calcium metabolism in our bodies.
The hormones secreted from these glands are Parathormone(PTH) and Calcitonin.


Measurement of Parathyroid glands

The anatomical measurements of this gland for one usually about 6 mm long and 3 to 4 mm wide, and 1 to 2 mm anteroposterior.


The function of Parathyroid glands

The parathyroid glands are essential for life, ad they are important for the regulation of the concentration of calcium ions in the body fluids. If parathyroidectomy did, the blood calcium level falls and causes neuromuscular irritability, the tetany.

The active principle of the parathyroid is parathormone(PTH) and acts in response to a lowering of blood calcium by stimulating the osteoclasts to resorb bone and free calcium ions from the reserve skeletal depots.

It regulates the excretion of inorganic phosphate in the urine.

Helps in Vit. D metabolism.


Classification of causes of hypercalcemia

Parathyroid related:
Primary hyperparathyroidism
  1. Solitary adenomas
  2. Multiple endocrine neoplasias
Lithium therapy
Familial hypocalciuric hypercalcemia

Vitamin D related:
Vitamin D intoxication
Raised 25(OH)3 D, sarcoidosis, and other granulomatous diseases.
Idiopathic hypercalcemia of infancy

Malignancy related
Solid tumor with metastases(breast)
Solid tumor with fluid-mediated hypercalcemia (lung, kidney)
Hematologic malignancies(multiple myeloma, lymphoma, leukemia)

Associated with high bone turnover
Immobilization
Thiazides
Vitamin A intoxication

Associated with renal failure
Severe secondary hyperparathyroidism
Aluminum intoxication
Milk alkali syndromes.


Diagnosis
Diminution of serum phosphorus(Normal 3mg / 100ml of blood)
Increased excretion of serum calcium in the urine ( upper limit of normal 250mg / 24hours in females, 300mg / 24 hours in males).
Elevation of serum parathyroid hormone concentration (upper limit of normal 0.5mg /1) by immuno-radio metric assay(IRMA)
MRI, CT and Tc 99m, MIBI studies

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