The diagnosis and management of severe hypercalcaemia: A simplified approach - Report of five cases

Hypercalcaemia, a common medical problem, can be a manifestation of various diseases. When severe, it can represent a medical emergency. Correct diagnosis is important to prevent unnecessary investigations and parathyroidectomies. We here present five patients with severe hypercalcaemia, most misdiagnosed for months or years before being referred to Sultan Qaboos University Hospital, Oman. We report how clinical examination, evaluation of fasting serum calcium, phosphate, creatinine and 24-hour urine calcium levels together with a review of their radiographics predicted the pathophysiology of the disorder and guided investigative procedures before hormone assays results were available.