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  • Title: Hypercalcaemia in the Johannesburg Hospital. Differential diagnosis and physician awareness of primary hyperparathyroidism.
    Author: Diamond TH, Botha JR, Vermaak WJ, Kalk WJ.
    Journal: S Afr Med J; 1987 Jul 18; 72(2):113-5. PubMed ID: 3616782.
    Abstract:
    A 1-year retrospective study of all serum profiles of patients with hypercalcaemia analysed at the Johannesburg Hospital was carried out to ascertain the causes of hypercalcaemia and physician awareness of primary hyperparathyroidism. Hypercalcaemia was found in 560 subjects (2.9% of 19,200), but in 147 of these (26%) this was not confirmed by repeat estimations. Malignant tumours were the commonest cause (38.4%) and accounted for the most severe hypercalcaemia (mean serum calcium 2.93 mmol/l). Renal disease resulted in significant hypercalcaemia, at times requiring parathyroidectomy. Drug-associated hypercalcaemia was usually mild and reversible on drug withdrawal. Although primary hyperparathyroidism occurred in 21.3% of cases, overall physician awareness of the disease was poor (39%). 'Incidental' profile hypercalcaemia (P less than 0.005) and hypertension (P less than 0.005) were frequent presenting features in this study. Renal disease (P less than 0.001) occurred infrequently.
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