Hypercalcaemia of Immobility in Critically Ill Patients: Case Series

Muhamad S Aljeaidi; Robert Palmer; Matthew H Anstey

doi:10.7759/cureus.43070

Hypercalcaemia of Immobility in Critically Ill Patients: Case Series

Cureus. 2023 Aug 7;15(8):e43070. doi: 10.7759/cureus.43070. eCollection 2023 Aug.

Authors

Muhamad S Aljeaidi^{1

2}, Robert Palmer², Matthew H Anstey^{1

2

3}

Affiliations

¹ Medical School, The University of Western Australia, Perth, AUS.
² Intensive Care Department, Sir Charles Gairdner Hospital, Perth, AUS.
³ School of Public Health, Curtin University, Perth, AUS.

Abstract

Significant hypercalcaemia can occur in intensive care unit (ICU) patients. Immobilisation hypercalcaemia has been infrequently reported after ICU admission. Patients, therefore, usually require extensive workup to rule out other common causes of hypercalcaemia, such as hyperparathyroidism. A case series of five patients who were diagnosed with hypercalcaemia due to immobilisation and received treatment with pamidronate between 2019 and 2023 were reported. The majority of cases were assessed as having hypercalcaemia due to immobilisation in the setting of low to normal parathyroid hormone levels, no suspicion of malignancy, and absence of other possible causative factors. Treatment with pamidronate started 10 to 60 days after hypercalcaemia was identified, and one or two doses of 30 mg of pamidronate were successful in resolving it. Immobilisation hypercalcaemia following ICU admission was uncommon but treatable with pamidronate.

Keywords: critical illness; hypercalcaemia; immobilisation; intensive care unit; pamidronate.

Publication types

Case Reports