Treatment of Hypercalcemia in Multiple Myeloma

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Abstract
Introduction Hypercalcemia is a frequent complication of multiple myeloma. In a large series, 28% of reported cases had a serum calcium over 15 mg. % on at least one determination.1 We have recently had experience with two patients and wish to present them as illustrating certain aspects of this clinical state and its treatment. Both Myers in his review of the treatment of hypercalcemia in malignancy2 and Adams et al. in their review of the management of multiple myeloma3 have noted the dangers of extreme hypercalcemia and have described the use of corticosteroid therapy. The neurologic and cardiac responses to extreme hypercalcemia are profound and lifethreatening. In addition, the effects of hypercalcemia on the kidney (i.e., osmotic diuresis, hyposthenuric polyuria, and renal failure) and on the gastrointestinal tract (i.e., anorexia, nausea, and vomiting) tend to increase the elevation of serum calcium. Corticosteroids have had a consistent and reproducible