小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 恶性肿瘤史
其他诊断因素
- 正常体格检查
- 皮肤张力差和/或粘膜干燥
- 意识模糊
- 疲劳
- 便秘
- 食欲不振
- 恶心
- 多尿
- 多饮
- 骨痛
- 使用诱发高钙血症的药物
- 木僵
- 昏迷
危险因素
- 非转移性恶性肿瘤
- 转移性骨骼受累
- 淋巴瘤
诊断性检查
首要检查
- 血清总钙
- 血清游离钙
- 血清白蛋白
- 综合代谢检查
- 静息心电图 (ECG)
- 血清甲状旁腺素
- 血清甲状旁腺素相关肽
- 血清磷
- 血清骨化三醇（1,25-二羟维生素D）
- 血清 25 -羟基维生素 D
需考虑的检查
- 骨骼检查
- 胸部 X 线检查
治疗流程
轻度高钙血症或无症状的中度高钙血症
有症状的中度或重度高钙血症：无晚期肾病
有症状的中度或重度高钙血症：伴晚期肾病
撰稿人
作者
Albert Shieh, MD
Assistant Professor of Medicine
Division of Geriatric Medicine
Department of Medicine
University of California, Los Angeles
Los Angeles
CA
利益声明
AS declares that he has no competing interests.
Dorothy Martinez, MD
Clinical Professor of Medicine
Division of Endocrinology
Department of Medicine
University of California, Los Angeles
Los Angeles
CA
利益声明
DM declares that she has no competing interests.
同行评议者
Ken C. Chiu, MD, FACE
Professor
Endocrinology Fellowship Training Program
Department of Clinical Diabetes, Endocrinology, and Metabolism
City of Hope National Medical Center
Duarte
CA
利益声明
KCC declares that he has no competing interests.
Richard Quinton, MD
Consultant and Senior Lecturer
Endocrine Unit
Newcastle University and Royal Victoria Infirmary
Newcastle-upon-Tyne
UK
利益声明
RQ has been reimbursed by Amgen, the manufacturer of Cinacalcet, for attending a conference and for giving an educational seminar (total under £1,200 over past 3 years).
鉴别诊断
- 原发性甲状旁腺功能亢进
- 甲状腺功能亢进
- 肾上腺皮质功能不全
更多 鉴别诊断指南
- 癌症症状管理指南：肿瘤急症
- 成人恶性肿瘤性高钙血症的治疗：美国内分泌学会临床实践指南
更多 指南
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