Hypo- and hypercalcaemia
Sorting hypercalcaemia by PTH, treating severe hypercalcaemia and malignancy, surgery thresholds in primary hyperparathyroidism, and managing acute and chronic hypocalcaemia.
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Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Correct calcium for albumin, or measure ionised calcium, before acting.
- Hypercalcaemia: about 90% is primary hyperparathyroidism (outpatients, mild, chronic) or malignancy (inpatients, higher, faster). PTH separates them.
- Severe hypercalcaemia is treated with fluids, then an antiresorptive. Calcitonin buys 48 hours.
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Sources
- Xgeva (denosumab) Australian Product Information, sections 4.1 and 4.2 (hypercalcaemia of malignancy refractory to IV bisphosphonate)AU/NZmedsinfo.com.au (sponsor Product Information), March 2026
- Treatment of hypercalcemia of malignancy in adults: an Endocrine Society clinical practice guidelineEndocrine Society (El-Hajj Fuleihan et al., J Clin Endocrinol Metab 2023;108:507-28), 2023
- Evaluation and management of primary hyperparathyroidism: summary statement and guidelines from the Fifth International WorkshopBilezikian et al., J Bone Miner Res 2022;37:2293-314, 2022
- Best practice recommendations for the diagnosis and management of hypoparathyroidismKhan et al., Metabolism 2025;171:156335, 2025
- Emergency management of acute hypocalcaemia in adult patientsSociety for Endocrinology (Endocrine Connections 2016), 2016
- Denosumab (Wyost, Jubbonti): Public Summary Document, November 2024 PBAC meeting (current Xgeva PBS listing)AU/NZPharmaceutical Benefits Advisory Committee, November 2024
- Yorvipath (palopegteriparatide) Australian public assessment report and PBS medicine statusAU/NZTherapeutic Goods Administration; Pharmaceutical Benefits Scheme, AusPAR August 2025; PBS status current at 1 November 2026
- Endocrinology (Therapeutic Guidelines)AU/NZTherapeutic Guidelines Ltd
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy