Skip to main content

Advertisement

SpringerLink
Log in

Hypercalcemia: a consultant’s approach

  • Educational Review
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Due to their daily involvement in mineral metabolism, nephrologists are often asked to consult on children with hypercalcemia. This might become even more pertinent when the hypercalcemia is associated with acute kidney injury and/or hypercalciuria and renal calcifications. The best way to assess the severity of hypercalcemia is by measurement of plasma ionized calcium, and if not available by adjusting serum total calcium to albumin concentration. The differential diagnosis of the possible etiologies of the disturbance in the mineral homeostasis starts with the assessment of serum parathyroid hormone concentration, followed by that of vitamin D metabolites in search of both genetic and acquired etiologies. Several tools are available to acutely treat hypercalcemia with the current main components being fluids, loop diuretics, and antiresorptive agents. This review will address the pathophysiologic mechanisms, clinical manifestations, and treatment modalities involved in hypercalcemia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Popovtzer MM (2003) Disorders of calcium, phosphorus, vitamin D and parathyroid hormone activity. In: Schrier RW (ed) Renal and electrolyte disorders, 6th edn. Lippincott Williams & Wilkins, Philadelphia, pp 216–277

    Google Scholar 

  2. Davies JH, Shaw NJ (2012) Investigation and management of hypercalcaemia in children. Arch Dis Child 97(6):533–538

    Article  PubMed  Google Scholar 

  3. Blaine J, Chonchol M, Levi M (2015) Renal control of calcium, phosphate, and magnesium homeostasis. Clin J Am Soc Nephrol 10:1257–1272

    Article  PubMed  CAS  Google Scholar 

  4. Bushinsky DA, Monk RD (1998) Electrolyte quintet: Calcium. Lancet 352(9124):306–311

    Article  PubMed  CAS  Google Scholar 

  5. Goltzman D (2000) Approach to Hypercalcemia. In: De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C (eds) Endotext. MDText.com, Inc., South Dartmouth, pp 1–44

    Google Scholar 

  6. Schlingmann KP, Kaufmann M, Weber S, Irwin A, Goos C, John U, Misselwitz J, Klaus G, Kuwertz-Bröking E, Fehrenbach H, Wingen AM, Güran T, Hoenderop JG, Bindels RJ, Prosser DE, Jones G, Konrad M (2011) Mutations in CYP24A1 and idiopathic infantile hypercalcemia. N Engl J Med 365:410–421

    Article  PubMed  CAS  Google Scholar 

  7. Molin A, Baudoin R, Kaufmann M, Souberbielle JC, Ryckewaert A, Vantyghem MC, Eckart P, Bacchetta J, Deschenes G, Kesler-Roussey G, Coudray N, Richard N, Wraich M, Bonafiglia Q, Tiulpakov A, Jones G, Kottler ML (2015) CYP24A1 mutations in a cohort of hypercalcemic patients: evidence for a recessive trait. J Clin Endocrinol Metab 100(10):E1343–E1352

    Article  PubMed  CAS  Google Scholar 

  8. Vahe C, Benomar K, Espiard S, Coppin L, Jannin A, Odou MF, Vantyghem MC (2017) Diseases associated with calcium-sensing receptor. Orphanet J Rare Dis. https://doi.org/10.1186/s13023-017-0570-z

  9. Riccardi D, Valenti G (2016) Localization and function of the renal calcium-sensing receptor. Nature 12:414–425

    CAS  Google Scholar 

  10. Tagiyev A, Demirbilek H, Tavil B, Buyukyilmaz G, Gumruk F, Cetin M (2016) Severe hypercalcemia in a child with acute lymphoblastic leukemia relapse: successful management with combination of calcitonin and bisphosphonate. J Pediatr Hematol Oncol 38(3):232–234

    Article  PubMed  Google Scholar 

  11. Davies JH (2015) Approach to the child with hypercalcaemia. Endocr Dev 28:101–118

    Article  PubMed  Google Scholar 

  12. Trehan A, Cheetham T, Bailey S (2009) Hypercalcemia in acute lymphoblastic leukemia: an overview. J Pediatr Hematol Oncol 31(6):424–427

    Article  PubMed  Google Scholar 

  13. Reynolds BC, Cheetham TD (2015) Bones, stones, moans and groans: hypercalcaemia revisited. Arch Dis Child Educ Pract Ed 100(1):44–51

    Article  PubMed  Google Scholar 

  14. Camirand A, Goltzman D, Gupta A, Kaouass M, Panda D, Karaplis A (2016) The role of parathyroid hormone-related protein (PTHrP) in osteoblast response to microgravity: mechanistic implications for osteoporosis development. PLoS One 11(7):xxx

    Article  CAS  Google Scholar 

  15. Lean JM, Matsuo K, Fox SW, Fuller K, Gibson FM, Draycott G, Wani MR, Bayley KE, Wong BR, Choi Y, Wagner EF, Chambers TJ (2000) Osteoclast lineage commitment of bone marrow precursors through expression of membrane-bound TRANCE†. Bone 27(1):29–40

    Article  PubMed  CAS  Google Scholar 

  16. Park HJ, Choi EJ, Kim JK (2016) A successful treatment of hypercalcemia with zoledronic acid in a 15-year-old boy with acute lymphoblastic leukemia. Ann Pediatr Endocrinol Metab 21(2):99–104

    Article  PubMed  PubMed Central  Google Scholar 

  17. Rodd C, Goodyer P (1999) Hypercalcemia of the newborn: etiology, evaluation, and management. Pediatr Nephrol 13(6):542–547

    Article  PubMed  CAS  Google Scholar 

  18. Tosur M, Patel KN, Swischuk LE, Lee PD (2017) Incidental Hypercalcemia caused by primary hyperparathyroidism with rapid progression to renal complications in a child. Clin Pediatr. https://doi.org/10.1177/0009922816685822

  19. Roizen J, Levine MA (2012) Primary hyperparathyroidism in children and adolescents. J Chin Med Assoc 75(9):425–434

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  20. Magalhães PK, Antonini SR, de Paula FJ, de Freitas LC, Maciel LM (2011) Primary hyperparathyroidism as the first clinical manifestation of multiple endocrine neoplasia type 2A in a 5-year-old child. Thyroid 21(5):547–550

    Article  PubMed  Google Scholar 

  21. Hechanova LA, Sadjadi SA (2014) Severe hypercalcemia complicating recovery of acute kidney injury due to rhabdomyolysis. Am J Case Rep 14(15):393–396

    Google Scholar 

  22. Alon U, Lovell HB, Donaldson DL (1992) Nephrocalcinosis, hyperparathyroidism and renal failure in familial hypophosphatemic rickets. Clin Pediatr 21:180–183

    Article  Google Scholar 

  23. Yavropoulou MP, Kotsa K, Gotzamani Psarrakou A, Papazisi A, Tranga T, Ventis S, Yovos JG (2010) Cinacalcet in hyperparathyroidism secondary to X-linked hypophosphatemic rickets: case report and brief literature review. Hormones 9:274–278

    Article  PubMed  Google Scholar 

  24. Nesbit MA, Hannan FM, Howles SA, Babinsky VN, Head RA, Cranston T, Rust N, Hobbs MR, Heath H 3rd, Thakker RV (2013) Mutations affecting G-protein subunit α11 in hypercalcemia and hypocalcemia. N Engl J Med 368:2476–2486

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  25. Nesbit MA, Hannan FM, Howles SA, Reed AA, Cranston T, Thakker CE, Gregory L, Rimmer AJ, Rust N, Graham U, Morrison PJ, Hunter SJ, Whyte MP, McVean G, Buck D, Thakker RV (2013) Mutations in AP2S1 cause familial hypocalciuric hypercalcemia type 3. Nat Genet 13(45):93–97

    Article  CAS  Google Scholar 

  26. Alon US, VanDeVoorde RG (2010) Beneficial effect of cinacalcet in a child with familial hypocalciuric hypercalcemia. Pediatr Nephrol 25:1747–1750

    Article  PubMed  Google Scholar 

  27. Wilhelm-Bals A, Parvex P, Magdelaine C, Girardin E (2012) Successful use of bisphosphonate and calcimimetic in neonatal severe primary hyperparathyroidism. Pediatrics 129:e812–e816

    Article  PubMed  Google Scholar 

  28. Powell BR, Blank E, Benda G, Buist NR (1993) Neonatal hyperparathyroidism and skeletal demineralization in an infant with familial hypocalciuric hypercalcemia. Pediatrics 91(1):144–145

    PubMed  CAS  Google Scholar 

  29. Glass EJ, Barr DG (1981) Transient neonatal hyperparathyroidism secondary to maternal pseudohypoparathyroidism. Arch Dis Child 56(7):565–568

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Savani RC, Mimouni F, Tsang RC (1993) Maternal and neonatal hyperparathyroidism as a consequence of maternal renal tubular acidosis. Pediatrics 91(3):661–663

    PubMed  CAS  Google Scholar 

  31. Jacobs TP, Bilezikian JP (2005) Clinical review: rare causes of hypercalcemia. J Clin Endocrinol Metab 90(11):6316–6322

    Article  PubMed  CAS  Google Scholar 

  32. Beckman MJ, Johnson JA, Goff JP, Reinhardt TA, Beitz DC, Horst RL (1995) The role of dietary calcium in the physiology of vitamin D toxicity: excess dietary vitamin D3 blunts parathyroid hormone induction of kidney 1-hydroxylase. Arch Biochem Biophys 319(2):535–539

    Article  PubMed  CAS  Google Scholar 

  33. Kara C, Çetinkaya S, Gündüz S, Can Yılmaz G, Aycan Z, Aydın M (2016) Efficacy and safety of pamidronate in children with vitamin D intoxication. Pediatr Int 58(7):562–568

    Article  PubMed  CAS  Google Scholar 

  34. Fencl F, Bláhová K, Schlingmann KP, Konrad M, Seeman T (2013) Severe hypercalcemic crisis in an infant with idiopathic infantile hypercalcemia caused by mutation in CYP24A1 gene. Eur J Pediatr 172(1):45–49

    Article  PubMed  Google Scholar 

  35. Bosch X (1998) Hypercalcemia due to endogenous overproduction of active vitamin D in identical twins with cat-scratch disease. JAMA 279(7):532–534

    Article  PubMed  CAS  Google Scholar 

  36. Monkawa T, Yoshida T, Hayashi M, Saruta T (2000) Identification of 25-hydroxyvitamin D3 1alphahydroxylase gene expression in macrophages. Kidney Int 58(2):559–568

    Article  PubMed  CAS  Google Scholar 

  37. Sebestyen VanSickle J, Srivastava T, Alon US (2017) Life-threatening hypercalcemia during prodrome of Pneumocystis jiroveci pneumonia in an immunocompetent infant. Glob Pediatr Health 3:1–4

    Google Scholar 

  38. Sfeir J, Zogala R, Popii V (2017) Hypercalcemia in necrobiotic xanthogranuloma: first reported case and insight into treatment. J Bone Miner Res 32(4):784–787

    Article  PubMed  Google Scholar 

  39. Bency R, Roger SD, Elder GJ (2011) Hypercalcaemia as a prodromal feature of indolent Pneumocystis jivorecii after renal transplantation. Nephrol Dial Transplant 26(5):1740–1742

  40. Hajji K, Dalle F, Harzallah A, Tanter Y, Rifle G, Mousson C (2009) Vitamin D metabolite-mediated hypercalcemia with suppressed parathormone concentration in Pneumocystis jiroveci pneumonia after kidney transplantation. Transplant Proc 41(8):3320–3322

    Article  PubMed  CAS  Google Scholar 

  41. Kallas M, Green F, Hewison M, White C, Kline G (2010) Rare causes of calcitriol-mediated hypercalcemia: a case report and literature review. J Clin Endocrinol Metab 95(7):3111–3117

    Article  PubMed  CAS  Google Scholar 

  42. Finne PH, Sanderud J, Aksnes L, Bratlid D, Aarskog D (1988) Hypercalcemia with increased and unregulated 1,25-dihydroxyvitamin D production in a neonate with subcutaneous fat necrosis. J Pediatr 112(5):792–794

    Article  PubMed  CAS  Google Scholar 

  43. Martínez de Zabarte Fernández JM, Laliena Aznar S, Corella Aznar E (2016) Subcutaneous fat necrosis and persistent hypercalcaemia in a newborn treated with therapeutic neonatal hypothermia. Arch Argent Pediatr 114(1):e13–e16

    PubMed  Google Scholar 

  44. Hazza IA, Ghandour MS, Almardini RI, Haddad RE, Salaita GM (2014) Hypercalcemia, hypercalciuria and nephrocalcinosis in a breast-fed term newborn: a rare presentation. Saudi J Kidney Dis Transpl 25(4):849–853

    Article  PubMed  Google Scholar 

  45. Kimura S, Nose O, Seino Y, Harada T, Kanaya S, Yabuuchi H, Itakura T, Takagi Y, Okada A (1986) Effects of alternate and simultaneous administrations of calcium and phosphorus on calcium metabolism in children receiving total parenteral nutrition. J Parenter Enter Nutr 10(5):513–516

    Article  CAS  Google Scholar 

  46. Schlingmann KP, Ruminska J, Kaufmann M, Dursun I, Patti M, Kranz B, Pronicka E, Ciara E, Akcay T, Bulus D, Cornelissen EA, Gawlik A, Sikora P, Patzer L, Galiano M, Boyadzhiev V, Dumic M, Vivante A, Kleta R, Dekel B, Levtchenko E, Bindels RJ, Rust S, Forster IC, Hernando N, Jones G, Wagner CA, Konrad M (2016) Autosomal-recessive mutation in SLC34A1 encoding sodium-phosphate cotransporter 2A cause idiopathic infantile hypercalcemia. J Am Soc Nephrol 27:604–614

    Article  PubMed  CAS  Google Scholar 

  47. Sargent JT, Smith OP (2010) Haematological emergencies managing hypercalcaemia in adults and children with haematological disorders. Br J Haematol 149(4):465–477

    Article  PubMed  CAS  Google Scholar 

  48. Çelik E, Özdemir GN, Tüysüz G, Taştan Y, Çam H, Celkan T (2014) A child presenting with hypercalcemia. Turk Pediatri Ars 49(1):81–83

    Article  PubMed  PubMed Central  Google Scholar 

  49. Kolyva S, Efthymiadou A, Gkentzi D, Karana-Ginopoulou A, Varvarigou A (2014) Hypercalcemia and osteolytic lesions as presenting symptoms of acute lymphoblastic leukemia in childhood. The use of zoledronic acid and review of the literature. J Pediatr Endocrinol Metab 27(3-4):349–354

    Article  PubMed  CAS  Google Scholar 

  50. Dufek S, Seidl R, Schmook M, Arbeiter K, Müller-Sacherer T, Heindl-Rusai K (2015) Intracranial hypertension in siblings with infantile hypercalcemia. Neuropediatrics 46(1):49–51

    Article  PubMed  Google Scholar 

  51. Kodous N, Filler G, Sharma AP, Van Hooren TA (2015) PTHrP-related Hypercalcaemia in infancy and congenital anomalies of the kidney and urinary tract (CAKUT). Can J Kidney Health Dis 11(2):21

    Google Scholar 

  52. Srivastava T, Kats A, Martin TJ, Pompolo S, Alon US (2011) Parathyroid hormone-related protein-mediated hypercalcemia in children with benign mesoblastic nephroma. Pediatr Nephrol 26:799–803

    Article  PubMed  Google Scholar 

  53. Mune T, Katakami H, Kato Y, Yasuda K, Matsukura S, Miura K (1993) Production and secretion of parathyroid hormone-related protein in pheochromocytoma: participation of an alpha-adrenergic mechanism. J Clin Endocrinol Metab 76(3):757–762

    PubMed  CAS  Google Scholar 

  54. Sindhar S, Lugo M, Levin MD, Danback JR, Brink BD, Yu E, Dietzen DJ, Clark AL, Purgert CA, Waxler JL, Elder RW, Pober BR, Kozel BA (2016) Hypercalcemia in patients with Williams–Beuren syndrome. J Pediatr 178:254–260

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  55. Helfrich A, Philla KQ (2015) Late-onset hypercalcemia in Williams–Beuren syndrome: importance of early and frequent screening and intervention. J Pediatr Endocr Met 28:425–428

    CAS  Google Scholar 

  56. Whyte MP (2016) Hypophosphatasia—aetiology, nosology, pathogenesis, diagnosis and treatment. Nat Rev Endocrinol 12(4):233–246

    Article  PubMed  CAS  Google Scholar 

  57. Nampoothiri S, Fernández-Rebollo E, Yesodharan D, Gardella TJ, Rush ET, Langman CB, Jüppner H (2016) Jansen metaphyseal chondrodysplasia due to heterozygous H223R-PTH1R mutations with or without overt hypercalcemia. J Clin Endocrinol Metab 101(11):4283–4289

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  58. Vyas AK, White NH (2011) Case of hypercalcemia secondary to hypervitaminosis a in a 6-year-old boy with autism. Case Rep Endocrinol 2011:424712

    PubMed  PubMed Central  Google Scholar 

  59. Barker ME, Blumsohn A (2003) Is vitamin a consumption a risk factor for osteoporotic fracture? Proc Nutr Soc 62(4):845–850

    Article  PubMed  CAS  Google Scholar 

  60. Safi KH, Filbrun AG, Nasr SZ (2014) Hypervitaminosis a causing hypercalcemia in cystic fibrosis. Case report and focused review. Ann Am Thorac Soc 11(8):1244–1247

    Article  PubMed  Google Scholar 

  61. Grinsell MM, Norwood VF (2009) At the bottom of the differential diagnosis list: unusual causes of pediatric hypertension. Pediatr Nephrol 24(11):2137–2146

    Article  PubMed  Google Scholar 

  62. Cano-Torres EA, González-Cantu A, Hinojosa-Garza G, Castilleja-Leal F (2016) Immobilization induced hypercalcemia. Clin Cases Miner Bone Metab 13(1):46–47

    PubMed  PubMed Central  Google Scholar 

  63. Vyas N, Kaminski B, MacLeish S (2016) A rare case report of immobility-induced Hypercalcemia in an infant. Pediatrics. https://doi.org/10.1542/peds.2015-0879

  64. Auron A, Alon US (2005) Resolution of medullary nephrocalcinosis in children with metabolic bone disorders. Pediatr Nephrol 20(8):1143–1145

    Article  PubMed  Google Scholar 

  65. Bettinelli A, Ciarmatori S, Cesareo L, Tedeschi S, Ruffa G, Appiani AC, Rosini A, Grumieri G, Mercuri B, Sacco M, Leozappa G, Binda S, Cecconi M, Navone C, Curcio C, Syren ML, Casari G (2000) Phenotypic variability in Bartter syndrome type I. Pediatr Nephrol 14:940–945

    Article  PubMed  CAS  Google Scholar 

  66. Gross I, Siedner-Weintraub Y, Simckes A, Gillis D (2015) Antenatal Bartter syndrome presenting as hyperparathyroidism with hypercalcemia and hypercalciuria: a case report and review. J Pediatr Endocrinol Metab 28(7-8):943–946

    Article  PubMed  CAS  Google Scholar 

  67. Pressey JG, Kelly DR, Hawthorne HT (2013) Successful treatment of preadolescents with small cell carcinoma of the ovary hypercalcemic type. J Pediatr Hematol Oncol 35(7):566–569

    Article  PubMed  Google Scholar 

  68. Drummond KN, Michael AF, Ulstrom RA, Good RA (1964) The blue diaper syndrome: familial hypercalcemia with nephrocalcinosis and indicanuria; a new familial disease, with definition of the metabolic abnormality. Am J Med 37:928–948

    Article  PubMed  CAS  Google Scholar 

  69. Kulpiya A, Mahachoklertwattana P, Pakakasama S, Hongeng S, Poomthavorn P (2012) Hypercalcemia and altered biochemical bone markers in post-bone marrow transplantation osteopetrosis: a case report and literature review. Pediatr Transplant 16(5):E140–E145

    Article  PubMed  Google Scholar 

  70. Saarela T, Simila S, Koivisto M (1995) Hypercalcemia and nephrocalcinosis in patients with congenital lactase deficiency. J Pediatr 127(6):920–923

    Article  PubMed  CAS  Google Scholar 

  71. Makaya T, Chatterjee S, Arundel P, Bevan C, Wright NP (2013) Severe hypercalcemia in diabetic ketoacidosis: a case report. Diabetes Care 36(4):e44

    Article  PubMed  PubMed Central  Google Scholar 

  72. Lietman SA, Germain-Lee EL, Levine MA (2010) Hypercalcemia in children and adolescents. Curr Opin Pediatr 22(4):508–515

    Article  PubMed  PubMed Central  Google Scholar 

  73. Tran HA, Song S, Crock PA, Mattes J, Howard K (2009) The a, B, C, D of hypercalcaemia in Down syndrome. BMJ Case Rep 9:2009

    Google Scholar 

  74. Hak EB, Crill CM, Bugnitz MC, Mouser JF, Chesney RW (2005) Increased parathyroid hormone and decreased calcitriol during neonatal extracorporeal membrane oxygenation. Intensive Care Med 31(2):264–270

    Article  PubMed  Google Scholar 

  75. Abdelmogheth AA, El-Baroudy I, Al-Yaaruby S (2013) Plasmapheresis-induced hypercalcaemia. Sultan Qaboos Univ Med J 13(1):147–151

    Article  PubMed  PubMed Central  Google Scholar 

  76. Lodefalk M, Frykholm C, Esbjörner E, Ljunggren Ö (2016) Hypercalcaemia in a patient with 2p13.2-p16.1 duplication. Horm Res Paediatr 85(3):213–218

    Article  PubMed  CAS  Google Scholar 

  77. Ahn SW, Kim TY, Lee S, Jeong JY, Shim H, Han YM, Choi KE, Shin SJ, Yoon HE (2016) Adrenal insufficiency presenting as hypercalcemia and acute kidney injury. Int Med Case Rep J 9:223–226

    Article  PubMed  PubMed Central  Google Scholar 

  78. De Rechter S, Levtchenko E, Evenepoel P, Mekahli D (2016) The case | Hypercalcemia in a child with chronic kidney disease. Kidney Int 90(1):233–234

    Article  PubMed  Google Scholar 

  79. Procino G, Mastrofrancesco L, Mira A, Tamma G, Carmosino M, Emma F, Svelto M, Valenti G (2008) Aquaporin 2 and apical calcium-sensing receptor: new players in polyuric disorders associated with hypercalciuria. Semin Nephrol 28(3):297–305

    Article  PubMed  CAS  Google Scholar 

  80. Khanna A (2006) Acquired nephrogenic diabetes insipidus. Semin Nephrol 26(3):244–248

    Article  PubMed  CAS  Google Scholar 

  81. Auron A, Tal L, Srivastava T, Alon US (2009) Reversal of hypercalcemic acute kidney injury by intravenous bisphosphonates. Pediatr Nephrol 24:613–617

    Article  PubMed  Google Scholar 

  82. Mulder JE, Bilezikian JP (2001) Acute management of hypercalcemia. In: Bilezikian JP, Marcus R, Levine MD (eds) The parathyroids, basic and clinical concepts, 2nd edn. Academic Press, San Diego, pp 729–741

    Google Scholar 

  83. Alon US, Scagliotti D, Garola RE (1994) Nephrocalcinosis and nephrolithiasis in infants with congestive heart failure treated with furosemide. J Pediatri 125:149–151

    Article  CAS  Google Scholar 

  84. Alon U, Berkowitz D, Berant M (1992) Idiopathic infantile hypercalcemia: rapid response to treatment with calcitonin. Child Nephrol Urol 12:47–50

    PubMed  CAS  Google Scholar 

  85. Sebestyen JF, Srivastava T, Alon US (2012) Bisphosphonates use in children. Clin Pediatr 51(11):1011–1024

    Article  Google Scholar 

  86. Nguyen M, Boutignon H, Mallet E, Linglart A, Guillozo H, Jehan F, Garabedian M (2010) Infantile hypercalcemia and hypercalciuria: new insights into a vitamin D- dependent mechanism and response to ketoconazole treatment. J Pediatr 125(2):296–302

    Article  CAS  Google Scholar 

  87. Timmers HJ, Karperien M, Hamdy NA, de Boer H, Hermus AR (2006) Normalization of serum calcium by cinacalcet in a patient with hypercalcaemia due to a de novo inactivating mutation of the calcium-sensing receptor. J Intern Med 260(2):177–182

    Article  PubMed  CAS  Google Scholar 

  88. Platt C, Inward C, McGraw M, Dudley J, Tizard J, Burren C, Saleem MA (2012) Middle-term use of cinacalcet in paediatric dialysis patients. Pediatr Nephrol 25(1):143–148

    Article  Google Scholar 

  89. Shroff R, Beringer O, Rao K, Hofbauer LC, Schulz A (2012) Denosumab for post-transplantation hypercalcemia in osteopetrosis. N Engl J Med 367(18):1766–1767

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank Ms. Andrea Fontana for her administrative assistance. This work was supported by the Sam and Helen Kaplan Research Fund in Pediatric Nephrology and the Eric McClure Research Fund in Bone and Mineral Metabolism.

Author information

Authors and Affiliations

  1. Bone and Mineral Disorders Clinic, Division of Pediatric Nephrology, Children’s Mercy Hospital, University of Missouri at Kansas City School of Medicine, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Ari Auron & Uri S. Alon

Authors
  1. Ari Auron
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Uri S. Alon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Uri S. Alon.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Additional information

Answers to questions:

1 d

2 a

3 c

4 d

5 a

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Auron, A., Alon, U.S. Hypercalcemia: a consultant’s approach. Pediatr Nephrol 33, 1475–1488 (2018). https://doi.org/10.1007/s00467-017-3788-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-017-3788-z

Keywords

Search

Navigation