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Principal Causes of Hypercalcemia

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Causes	Descriptions	Examples
Humoral hypercalcemia of malignancy	Excessive bone resorption	Bladder Breast Leukemia Lymphoma Ovarian Prostate Renal cell Squamous cell (lung, head and neck)
Osteolytic hypercalcemia of malignancy, due to bone metastases or hematologic cancer	—	Leukemia Lymphoma Metastatic breast, prostate, non-small cell lung cancers Multiple myeloma
Increased mobilization of calcium from bone	—	Hyperthyroidism Immobilization (eg, orthopedic casting traction) Osteoporosis in older adults Paget disease of bone Paraplegia or quadriplegia Rapid growth during childhood and adolescence
Parathyroid hormone excess	—	Familial hypocalciuric hypercalcemia Parathyroid carcinoma Primary hyperparathyroidism Secondary hyperparathyroidism Tertiary hyperparathyroidism
Vitamin toxicity	—	Vitamin A toxicity Vitamin D toxicity
Granulomatous diseases	Excessive gastrointestinal tract calcium absorption, intake, or both	Berylliosis Coccidioidomycosis Histoplasmosis Leprosy Sarcoidosis Silicosis Tuberculosis
Other disorders	—	Milk-alkali syndrome Vitamin D toxicity
Medications	Other mechanisms	Lithium toxicityLithium toxicity Theophylline toxicityTheophylline toxicity Thiazide treatment
Endocrine dysfunction	—	Addison disease Cushing disease, postoperative Myxedema
Other disorders	—	Aluminum-induced osteomalacia Idiopathic infantile hypercalcemia Neuroleptic malignant syndrome
Artifactual	—	Exposure of blood to contaminated glassware Prolonged venous stasis as blood sample was obtained