A 70 year old female presents with confusion and weakness
Very severe hypercalcaemia in a patient with history of thyroid disease.
Causes of hypercalcaemia:
Drugs – Thiazides
Paget’s disease, Parenteral nutrition, Parathyroid disease.
Vitamins A & D excess
The patient requires admission for workup of the possible causes for her hypercalcaemia
Encourage mobilisation and weight bearing
Others depend on the cause identified:
Reduce dietary intake of Calcium and Vit D
Long term treatment may include the use of Bisphosphonates to reduce bone resorption esp in Malignancy, other agents – Immune mediators/ suppressors, hormonal therapy with Calcitonin/ steroids etc
Orthopaedic input for possible Orthopaedic complications