How should patients with hypercalcemia be evaluated?

Updated: Apr 11, 2018
  • Author: Thomas E Green, DO, MPH, MMM, CPE, FACEP, FACOEP; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

A study by Balentine et al suggested that a large percentage of patients with hypercalcemia are not appropriately evaluated for hyperparathyroidism, while many of those who are diagnosed with hyperparathyroidism do not get a surgical referral. Looking at figures from a tertiary referral center, the investigators found that only 3200 (31%) of 10,432 patients with hypercalcemia underwent parathyroid hormone measurement, with a hypercalcemia diagnosis documented in just 2914 patients (28%) and a hyperparathyroidism diagnosis found in the medical records of 880 patients (8%). Of 2666 patients with classic hyperparathyroidism (ie, abnormal calcium and parathyroid hormone levels), only 592 (22%) received a surgical referral. [17]


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