Parathyroid hormone-related |
Primary hyperparathyroidism* |
| Sporadic, familial, associated with multiple endocrine neoplasia I or II |
Tertiary hyperparathyroidism |
| Associated with chronic renal failure or vitamin D deficiency |
Vitamin D-related |
Vitamin D intoxication |
| Usually 25-hydroxyvitamin D2 in over-the-counter supplements |
Granulomatous disease sarcoidosis, berylliosis, tuberculosis |
Hodgkin's lymphoma |
Malignancy |
Humoral hypercalcemia of malignancy* (mediated by PTHrP) |
| Solid tumors, especially lung, head, and neck squamous cancers, renal cell tumors |
Local osteolysis* (mediated by cytokines) multiple myeloma, breast cancer |
Medications |
Thiazide diuretics (usually mild)* |
Lithium |
Milk-alkali syndrome (from calcium antacids) |
Vitamin A intoxication (including analogs used to treat acne) |
Other endocrine disorders |
Hyperthyroidism |
Adrenal insufficiency |
Acromegaly |
Pheochromocytoma |
Genetic disorders |
Familial hypocalciuric hypercalcemia: mutated calcium-sensing receptor |
Other |
Immobilization, with high bone turnover (e.g., Paget's disease, bedridden child) |
Recovery phase of rhabdomyolysis |