title: Diagnosis of patients with raised serum calcium level in primary care, Sweden.
abstract: OBJECTIVE
  To study the diagnosis of hypercalcaemic patients and to evaluate whether frequent analyses of serum calcium can detect more patients with hypercalcaemia.
  
  
  METHODS
  Retrospective study of serum calcium analyses performed during the time period 1992-2000 and of the medical records of patients with elevated serum calcium levels between 1995 and 2000.
  
  
  METHODS
  Primary care in Tibro, Sweden.
  
  
  METHODS
  Patients from the local community attending the primary healthcare centre.
  
  
  METHODS
  Frequency of serum calcium analyses, hypercalcaemic patients, and their diagnosis.
  
  
  RESULTS
  Doubling the number of serum calcium analyses did not increase the detected number of raised calcium levels. On the other hand, more frequent parathyroid hormone (PTH) analyses resulted in a corresponding increase in detected high PTH levels. In Tibro, 15% (n = 22) of the patients with hypercalcaemia were diagnosed with primary hyperparathyroidism, giving a rate of 0.22%. This is comparable to the prevalence in other population studies. Over 40% (n = 9) of patients with primary hyperparathyroidism in the study had only slightly raised serum calcium levels (2.55-2.60 mmol/l). In 70% (n = 99) of the cases, the cause of hypercalcaemia was unknown. The second most common diagnosis was skeletal disorders followed by kidney disease.
  
  
  CONCLUSIONS
  An increase in the number of serum calcium analyses did not result in increased detection of raised calcium levels. In contrast, an increase in the number of PTH analyses resulted in increased detection of primary hyperparathyroidism. Therefore, PTH analyses should be used more frequently.
authors.affiliation: R&D Centre, Skaraborg Primary Care, Skövde, Sweden. sofia.dalemo@vgregion.se
authors.forename: Sofia
authors.initials: S
authors.lastname: Dalemo
authors.forename: Per
authors.initials: P
authors.lastname: Hjerpe
authors.forename: Kristina
authors.initials: K
authors.lastname: Boström Bengtsson
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood*; D005194:Family Practice; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis* / Q000453:epidemiology; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D012016:Reference Values; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium