All of the following are causes of hypercalcemia ‘except-
Correct Answer: Hypothyroidism
Description: Hypercalcaemia is one of the most common biochemical abnormalities and is often detected during routine biochemical analysis in asymptomatic patients. However, it can present with chronic symptoms, as described below, and occasionally as an acute emergency with severe hypercalcaemia and dehydration. Causes of hypercalcaemia are listed in Box 20.36. Of these, primary hyperparathyroidism and malignant hypercalcaemia are by far the most common. Familial hypocalciuric hypercalcaemia (FHH) is a rare but impoant cause that needs differentiation from primary hyperparathyroidism (HPT). Lithium may cause hyperparathyroidism by reducing the sensitivity of the calcium-sensing receptor. With normal or elevated PTH levels *Primaryoeiaryhyperparathyroidism *Lithium-inducedhyperparathyroidism *Familialhypocalciurichypercalcaemia With low PTH levels *Malignancy(lung,breast,myeloma,renal,lymphoma, thyroid) *Elevated1,25(OH)2vitaminD(vitaminDintoxication, sarcoidosis,HIV,othergranulomatousdisease) *Thyrotoxicosis *Paget'sdiseasewithimmobilisation *Milk-alkalisyndrome *Thiazidediuretics *Glucocoicoiddeficiency DAVIDSONS PRINCIOLES AND PRACTICE OF MEDICINE 22ND EDITION PAGE NO-767
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