Diagnostic studies-hypercalcemia

hyperparathyroidism

• Hyperparathyroidism (HPT) and malignancy account for 90% of cases of ↑ Ca; HPT more likely if asx or chronic; malignancy (usually overt) more likely if acute or sx
  • 甲狀旁腺功能亢進（HPT）和惡性腫瘤佔↑Ca病例的90%；
  • 如果 asx 或慢性，HPT 更有可能；如果急性或 sx，則更有可能發生惡性腫瘤（通常是明顯的）
  • Parathyroid MIBI Scan
• Ca, alb, ICa, PTH (may be inapprop. normal in 1° HPT & FHH; JAMA 2014;312:2680), PO4

↑ or high nl PTH: Ca/Cr clearance ratio <0.01 → FHH ↓ PTH: ✓ PTHrP, Aϕ, & search for malig (eg, CT, mammogram, SPEP/UPEP) and ✓ vit D: ↑ 25-(OH)D → meds; ↑ 1,25-(OH)2D → granuloma (✓ CXR, ACE, r/o lymph)