Immobilization hypercalcemia.

Three cases of immobilization hypercalcemia are presented and the incidence, clinical symptoms, laboratory investigation, pathophysiology and treatment of this metabolic abnormality are reviewed. Immobilization hypercalcemia is more common that has previously been suspected. Vague clinical symptoms may not suggest the diagnosis of hypercalcemia. Laboratory investigation of these clinical complaints in the immobilized patient should include determination of the serum calcium and total protein levels and the urinary calcium to creatinine ration. The pathophysiology of this entity is unknown. Treatment is directed towards lowering the serum calcium level using intravenous hydration, furosemide and salmon calcitonin. Definitive treatment consists of mobilizing the patient. Exercises in bed have not been effective in preventing or treating immobilization hypercalcemia.