Overview
Why Malignant Hypercalcemia Becomes an Emergency
Malignant hypercalcemia is a corrected serum calcium concentration greater than 2.6 mmol/L caused by cancer related calcium release or altered calcium handling.
Malignant hypercalcemia is a corrected serum calcium concentration greater than 2.6 mmol/L caused by cancer-related calcium release or altered calcium handling. Calcium excess promotes polyuria, gastrointestinal slowing, weakness, and neurologic changes; the resulting fluid loss reduces renal calcium clearance and can intensify the hypercalcemia. A corrected calcium of at least 3.5 mmol/L, new mental-status change, cardiac arrhythmia, or renal failure makes this a medical emergency. Begin intravenous isotonic saline immediately and follow the local provincial emergency protocol while urgent antiresorptive treatment is arranged.