Hyperkalsemian

Hyperkalsemian is a rare or informal term for an individual with hypercalcemia, an elevated calcium level in the blood. Clinically, hypercalcemia is usually defined as total serum calcium above 10.5 mg/dL (2.62 mmol/L). The term is not common in formal guidelines, but may appear in case reports.

Patients may have mild nonspecific symptoms or more serious effects. Common signs include fatigue, weakness, polyuria, polydipsia, constipation, nausea, and cognitive changes. Chronic hypercalcemia can cause bone pain, kidney stones, and hypertension; severe hypercalcemia may trigger life-threatening arrhythmias or coma.

Causes are divided into PTH-dependent and PTH-independent. Common PTH-dependent causes include primary hyperparathyroidism. PTH-independent causes include malignancy with PTH-related peptide, excessive vitamin D, granulomatous diseases, medications such as thiazides or lithium, and immobilization.

Diagnosis starts with measuring total and ionized calcium, corrected for albumin. Simultaneous PTH level helps classify etiology. Further tests may include PTHrP, 25-hydroxyvitamin D, renal function, and imaging to locate adenomas or identify malignancy.

Management depends on severity and cause. In acute cases, intravenous isotonic saline hydration is first-line, with calcitonin for rapid but temporary reduction. Bisphosphonates or denosumab are used for longer-term control. Treat underlying causes, potentially including parathyroidectomy for primary hyperparathyroidism or cancer-directed therapy.

Etymology: The form derives from Latin/calcium roots meaning excess calcium. In formal medical writing, hypercalcemia or hypercalcemic is preferred over hyperkalsemian.