Clinical features at the time of initial diagnosis in patients with cancer-related hypercalcemia

AIM: Hypercalcemia is a common electrolyte disturbance in internal medicine practice, which can lead to various complications and, in some cases, can be life-threatening. The aim of this study is to identify the characteristics of patients hospitalized in the internal medicine department due to hypercalcemia based on clinical, laboratory, imaging, and pathology results, and to investigate parameters that may predict malignant hypercalcemia. MATERIALS AND METHODS: In this retrospective study, the demographic data, comorbidities, clinical features, laboratory parameters, and diagnoses of patients hospitalized in the Internal Medicine Department of Sakarya Education and Research Hospital due to hypercalcemia were evaluated. RESULTS: In the study, hypercalcemia secondary to malignancy was found in 82 out of 133 patients, while 51 patients had hypercalcemia due to non-malignant causes. The most common malignancy was lung cancer, while the most frequent non-malignant cause was primary hyperparathyroidism. The presence of weight loss was identified as a significant parameter for the presence of malignancy (p=<0.001). In patients with malignant hypercalcemia, age, PTH, and albumin were found to be significantly lower, while corrected calcium, phosphorus, ALP, GGT, and LDH were significantly higher (all p<0.05). According to logistic regression analysis, gender, age, weight loss, albumin, and phosphorus levels were found to be significant factors in diagnosing malignancy. CONCLUSION: In patients hospitalized due to hypercalcemia, the most common etiology among malignant cases is lung cancer, while among benign cases, it is primary hyperparathyroidism. To differentiate between malignant hypercalcemia and non-malignant hypercalcemia, age, PTH, albumin, corrected calcium, phosphorus, ALP, GGT, and LDH values are significant laboratory findings. Additionally, in patients hospitalized due to hypercalcemia, gender, age, weight loss, albumin, and phosphorus levels are significant predictive parameters for diagnosing malignancy. Keywords: Hypercalcemia, Malignancy, Parathyroid hormone, Primary hyperparathyroidism