[Hypercalcemia in myeloma].

Hypercalcemia arises in the advanced stage of myeloma due to marked increase in osteoclastic bone resorption by local factors in the bone marrow, and is among the most serious complications in myeloma. It can progress rapidly and provoke acute renal failure and coma, which may become life-threatening. Early detection by serum calcium levels and treatment of hypercalcemia is important, although its clinical symptoms are difficult to distinguish from those in other underlying complications. Bisphosphonates, potent inhibitors of bone resorption, are recommended as the most effective therapy and have been approved for treatment of hypercalcemia in myeloma.