Prevalence of hypercalcaemia in a health survey: a 14‐year follow‐up study of serum calcium values

Abstract

Among 16,401 subjects attending two health screenings, in 1969 and 1971, 176 showed hypercalcaemia on both occasions, i.e. serum calcium values above 2.60 mmol l-1. The prevalence of hypercalcaemia increased in women with advancing age and occurred in close to 3% of those above the age of 60, whilst in men it was found in less than 0.7% in all age groups. The mean serum calcium concentration in women above the age of 50 was significantly higher than in men. This observation could at least partly explain why hyperparathyroidism (HPT) is more often diagnosed in females. Only nine persons were initially referred for neck exploration. Most of the others were not even notified of the biochemical disturbance and thus it was possible to study the serum calcium values in an unattended cohort until follow-up after 14 years. In the hypercalcaemic patients there was little or no increase in serum calcium during these years. In no patient did the serum calcium level rise above 3.0 mmol l-1. Altogether, 24 patients from the initial cohort were subsequently operated on for primary HPT but there were only two further cases of verified HPT, which developed during the follow-up period, in those who had been clearly normocalcaemic at the health surveys. In conclusion, hypercalcaemia, presumably caused by primary HPT, is common but apparently develops slowly and with little risk of a progressive rise of serum calcium concentrations.

Persistent disease after surgery for primary hyperparathyroidism: the long-term outcome

“…et al (5). Mean follow-up time was greater than 10 years in three of these studies (1,6,12), and 8.2 years in one (5). In the remaining it was 3.5 -5.6 years (2 -4), which might not suffice for forming an opinion.…”

Diagnosis of patients with raised serum calcium level in primary care, Sweden

“…Studies limiting the subject population to retirees or females 55 to 75 years of age detected a prevalence of about 2% (see Table I). The lower age limit in the Tromsö, Gävle, and Stockholm [9,10,12] studies was 20 Á25 years while the rate in Tibro was calculated for a population aged 7 years and older, as this was the age of the youngest patient with hypercalcaemia. With a lower age limit of 45 years, a rate of 0.43% would have been registered in this study.…”

“…To detect more patients with pHPT, the Swedish authorities encouraged an increase in serum calcium analyses in primary care [8]. In the majority of patients serum calcium levels remain stable over decades [9,10], but in a small proportion Correspondence: Sofia Dalemo, Guldvingens Health Care Centre, Ö stbygatan 21 Á23, SE-531 37 Lidkö ping, Sweden. E-mail: sofia.dalemo@vgregion.se…”

Influence of renal function on clinico-pathological features of primary hyperparathyroidism

“…The incidence and severity of this renal impairment vary considerably among reports, probably due to both the heterogeneity of the patient samples studied and the different techniques used for estimating renal function. Several authors who monitored plasma creatinine levels in pHPT patients reported that renal function might remain normal despite long-standing hypercalcemia (11,12).…”