title: Hypercalcemia in the Intensive Care Unit: A Review of Pathophysiology, Diagnosis, and Modern Therapy.
abstract: Hypercalcemia may be seen in a variety of clinical settings and often requires intensive management when serum calcium levels are dramatically elevated. All of the many etiologies of mild hypercalcemia can lead to severe hypercalcemia. Knowledge of the physiologic mechanisms involved in maintaining normocalcemia and basic pathophysiology is essential for making a timely diagnosis and hence prompt institution of etiology-specific therapy. The development of new medications and critical reviews of traditional therapies have changed the treatment paradigm for severe hypercalcemia, calling for a more limited role for aggressive isotonic fluid administration and furosemide and an expanded role for calcitonin and the bisphosphonates. Experimental therapies such as denosumab show promise.
authors.affiliation: Department of Medicine, Section of Endocrinology and Metabolism, Overton Brooks Veterans Administration Medical Center, Shreveport, LA, USA joshua.maier@va.gov.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Maier
authors.affiliation: Department of Medicine, Section of Endocrinology and Metabolism, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Levine
mesh_terms: D002118:Calcium / Q000097:blood / Q000378:metabolism*; D003937:Diagnosis, Differential; D005440:Fluid Therapy; D006706:Homeostasis; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D007362:Intensive Care Units; D010281:Parathyroid Hormone / Q000378:metabolism
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium
keywords: hypercalcemia; hyperparathyroidism; malignancy-associated hypercalcemia; parathyroid hormone–related protein