Protocolo terapéutico de la hipercalcemia

Resum

Hypercalcemia is a disorder that usually is due to the presence of a malignant tumour or a primary hyperparathyroidism. Although there is no deifinition of severe hypercalcemia, crisis of this condition are characterized by serum calcium > 14 mg/dl, with acute symtoms including hypercalcemia and the require a rapid treatment to control. Correction of total calcium with seroalbulmin levels are recommended, and the assay of ionized calcium can be necessary in certain circunstances. The finding of PTH not suppress or elevated, suggest primary hyperparathyroidism. If PTH is suppress in the presence of of hypercalcemia, hyperpathyroidism in probably a finding. PTHrp can also be assay, in those cases of hypercalcemia mediated by malingnacies. The presence of hypercalcemia in granulomatous diseases -sarcoidosis- require the assay of calcitriol. Also is is necessary to perform scanners and magnetic resonance studies for the study of hypercalcemia for excluding tumours. Treatment is going to dependent of the levels, chronicity and cause of the hypercalcemia. An adequiate hydratation, with enhacement of calcium urinary excetion, and drugs to reduce osteoclastic activity are main principies. Bisphosphonates and calciomimetics are the most efectives and used in the actuality.