ABSTRACT
Background: Hypercalcemia is a common metabolic abnormality of varying severity that can be adequately diagnosed and treated. Primary hyperparathyroidism and malignant neoplasms are responsible for >90% of all cases. Objectives: To study the clinical presentation and etiological profile of hypercalcemic patients at a district level hospital over a period of 24 months. The number of patients of hypercalcemia due to other rare cause like vitamin D intoxication have been increasing mainly due to over the counter supplementation. Methods: Forty patients, 22 males with a mean age of 50±10.2 and 18 females with mean age 45±7.6 with hypercalcemia were studied. The first step in evaluating hypercalcemia was confirming it first, with an initial evaluation including the measurement of intact parathyroid hormone , 25-hydroxy vitamin D levels and alongwith imaging wherever required. Results: Out of 40 patients studied, the most common clinical presentations were symptoms of aches and pains in 12 patients and incidental finding of hypercalcemia in 10 patients, altered sensorium in 6 patients. In etiological profile, the most common etiology was vitamin D intoxication in 10 patients followed by hyperparathyroidism in 9 patients and malignanacy in 7 patients respectively. Conclusion: In our study vitamin D intoxication (VDI) was the most common cause of hypercalcemia. as compared with multiple studies previously which showed malignancy and hyperparathyroidism as predominant causes. Inadvertent excessive use of pharmaceutical preparations is the most common etiology of exogenous vitamin D toxicity.