common and most treatable paraneoplastic syndrome

malignant tumour production of PTHRP, more common in SCLC, breast cancer and multiple myeloma

Clinical Features

• can be asymptomatic

  can become symptomatic rapidly and may require urgent intervention

• Nausea/vomiting

• confusion/delirium

• increased pain

• constipation

• thirst

• polyuria

Managment

• IV rehydration then bisphosphonate (zoledronic acid)
  • rehydrate first to prevent calcium deposition in kidney → renal failure
  • care for fluid overload
• The urgency of treatment depends on the severity of the hypercalcaemia and associated symptoms, and the patient's place in the course of their illness.
• recurrent or symptomatic and poorly responsive to treatment generally indicates the condition is becoming refractory to treatment and the patient is reaching the terminal phase.

Complications