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Version Date from Date to Amendment 

1.0 Sept 2014 Sept 2016 Original 
2.0 Aug 2021 Aug 2023 Edited document 

OUTPATIENT GP REFERRAL GUIDELINES 
SOUTHERN ADELAIDE DIABETES and ENDOCRINE SERVICES (SADES) 

Southern Adelaide Local Health Network (SALHN) 

Hypercalcaemia   cause uncertain 
Common causes are 

  Primary hyperparathyroidism
  Malignancy
  Drugs
  Other causes are rare and generally require endocrine assessment

Information Required 
  Presence of Red Flags
  Duration of symptoms
  Associated symptoms
  Past medical and family history
  Current drug therapy (and previous lithium use)

Investigations Required 
  Total and corrected serum calcium   repeat

fasting if borderline
  Serum PTH, PO4, ALP and 25OH vitamin D,

creatinine
  Second void fasting morning spot urine for

calcium and creatinine
  DEXA if minimal trauma fracture or loss of height

Fax Referrals to 
GP Plus Marion 7425 8687 GP Plus Noarlunga  8164 9199 

Red Flags 
Known or suspected malignancy   if confirmed as the cause of hypercalcaemia refer to oncology or 
relevant surgical unit 
Nausea, vomiting, dehydration, weight loss or diminished conscious state 
Corrected serum calcium &gt;3 mmol/L 
Rapid renal function deterioration 
Recurrent renal calculi 
Pancreatitis 

Suggested GP Management 
  Ensure hypercalcaemia is real by using corrected

serum calcium
  Cease potential exacerbating drugs (e.g. thiazides ,

calcitriol   lithium if safe to do so)
  Maintain hydration

Clinical Resources 
  Therapeutic Guidelines Endocrinology Version 6

(2018)
https://tgldcdp.tg.org.au/viewTopic?topicfile=hyper
parathyroidism

General Information to assist with referrals and the and Referral templates for SALHN are available to download from the SALHN 
Outpatient Services website www.sahealth.sa.gov.au/SALHNoutpatients and SAFKI Medicare Local website www.safkiml.com.au  

Identifier: CC1.2713




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