1- Malignancy- Multiple myeloma. • Boney metastasis
- Hormonal factors (PTH-like substance) secreted by tumour cells.
2- Hyperparathyroidism
3- Sarcoidosis
4- Bone disease - Paget's disease • Aluminium osteodystrophy
5- Calcium or vitamin D related - Vitamin D intoxication • Thiazide diuretics
- Milk-alkali syndrome • Renal failure
6- Endocrine disease - Thyrotoxicosis
- Addison's disease
7- Hyperproteinaemia
(only non-ionised calcium is raised)
Clinical features
1- Manifestations of the etiologic cause
2- Renal manifestations
- Polyuria and polydepsia resulting from urinary concentration
defect - Stone disease and nephrocalcinosis
- Acute renal failure may occur with severe hypercalcaemia and the
associated dehydration owing to polyuria - Chronic renal failure due to stone disease, nephrocalcinosis and
chronic tubulointerstitial nephritis.
3- Gastrointestinal manifestations