A hypercalcaemiccrisisis an emergency situation with a severehypercalcaemia, generally above approximately 14 mg/dL (or 3.5 mmol/l)
The most common cause is hypercalcemia of malignancy,
although granulomatous diseases, previously undetected primary hyperparathyroidism, medication-induced hypercalcemia, and a few rarer
causes may result in this endocrine emergency as well.
Stepwise approach for management of
Hypercalcemic crisis
Step 1:
Confirm the diagnosis.
Step 2:
Restore normal hydration - Through IV fluids(200-500 ml/hr of NS )should be administered to maintain a urine output of >100 ml/hr.
Step 3:
• Use of loop diuretics to be limited to
hypercalcemic crisis associated with heart failure or renal failure.
Calcitonin or bisphosphonates-Preferred drugs for hypercalcemic management after restoring normal hydration with IV fluids.