Vergès B
Service d'Endocrinologie, Diabétologie et Maladies métaboliques, Hôpital du Bocage, F 21000 Dijon. bruno.verges@chu-dijon
Presse Med. 2001 Feb 24;30(7):313-6.
A COMMON FINDING: Hypercalcemia is not rare among elderly patients. Hyperparathyroidism and neoplasia are the most frequent causes of hypercalcemia in old patients. Symptoms due to hypercalcemia are usually non specific in old subjects, leading to consider easily this diagnosis and to measure plasma calcium level.
Biological diagnosis of hypercalcemia is not always obvious in old patients because of frequently decreased plasma albumin levels leading to lower plasma total calcium level. Thus, it is always necessary to calculate plasma total calcium level corrected by albumin in order not to underestimate hypercalcemia in elderly subjects.
The short-term risk of hypercalcemia is acute hypercalcemia, which may be lifethreatening. The long-term risk of hypercalcemia is renal failure.
When hypercalcemia is due to primary hyperparthyroidism, the treatment of choice is surgery. However, for old patients with high surgical risk surgery with local anesthesia or ultrasonically guided percutaneous ethanol injection into parathyroid adenoma can be proposed.
常见发现：高钙血症在老年患者中并不罕见。甲状旁腺功能亢进和肿瘤是老年患者高钙血症最常见的病因。老年患者因高钙血症引起的症状通常不具有特异性，这使得人们很容易考虑到这一诊断并测量血浆钙水平。
由于老年患者血浆白蛋白水平经常降低导致血浆总钙水平降低，高钙血症的生物学诊断在老年患者中并不总是显而易见的。因此，为了不低估老年患者的高钙血症，始终有必要计算经白蛋白校正的血浆总钙水平。
高钙血症的短期风险是急性高钙血症，这可能危及生命。高钙血症的长期风险是肾衰竭。
当高钙血症是由原发性甲状旁腺功能亢进引起时，首选治疗方法是手术。然而，对于手术风险高的老年患者，可以考虑局部麻醉下手术或超声引导下经皮乙醇注射到甲状旁腺腺瘤中。
