Endocrine Abstracts (2019) 65 NS2.2 | DOI: 10.1530/endoabs.65.NS2.2

Patient management of hypercalcaemia and when should the surgeon intervene?

Neil Gittoes


Centre for Endocrinology, Diabetes and Metabolism, Birmingham, UK


Hypercalcaemia is common and can represent a broad spectrum of underlying diseases that range from common to extremely rare. Furthermore, causes of hypercalcaemia can be mild and indolent or may be rapidly progressive and represent serious underlying diseases such as cancers. It is thus important to have a clear understanding of hypercalcaemia, particularly its early assessment and management that will lead to a diagnosis of the underlying cause. Hypercalcaemia can present as an emergency or may be a consistent finding on laboratory tests over a protracted period. The talk will cover acute management of hypercalcaemia, diagnostic work up and a focus on differential diagnoses. Longer term management of endocrine causes of hypercalcaemia will be explored, particularly primary hyperparathyroidism. The recent NICE guideline on primary hyperparathyroidism (PHPT), NG132, will be reviewed with an emphasis on investigations to exclude mimics of PHPT, considerations around the role of surgery and a rational approach to imaging prior to surgery. Use of bisphosphonates and cinacalcet will also be explored in patients with PHPT. A plan for longer term follow up of patients with PHPT will be proposed, encompassing those who have and those who have not received successful parathyroid surgery. The utility of genetic testing in patients with PHPT will also be covered.

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