Hypercalcemia in the elderly

A common finding: Hypercalcemia is not rare among elderly patients. Hyperpa rathyroidism and neoplasia are the most frequent causes of hypercalcemia in old patients. Symptoms due to hypercalcemia are usually non specific in ol d subjects, leading to consider easily this diagnosis and to measure plasma calcium level. Diagnosis: Biological diagnosis of hypercalcemia is not always obvious in o ld patients because of frequently decreased plasma albumin levels leading t o lower plasma total calcium level. Thus, it is always necessary to calcula te plasma total calcium level corrected by albumin in order not to underest imate hypercalcemia in elderly subjects. Prognosis: The short-term risk of hypercalcemia is acute hypercalcemia, whi ch may be lifethreatening. The long-term risk of hypercalcemia is renal fai lure. Treatment: When hypercalcemia is due to primary hyperparthyroidism, the tre atment of choice is surgery. However, for old patients with high surgical r isk surgery with local anesthesia or ultrasonically guided percutaneous eth anol injection into parathyroid adenoma can be proposed. (C) 2001, Masson, Paris.