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Multiple myeloma with hypercalcemia (corrected serum calcium ≥11 mg/dL or symptomatic): p...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-MM-HYPERCALCEMIA
TypeRed flag
Statusreviewed 2026-04-27 | pending_clinical_signoff
DiseasesDIS-MM
SourcesSRC-EHA-EMN-MM-2025 SRC-ESMO-MM-2023 SRC-NCCN-MM-2025

Red Flag Origin

DefinitionMultiple myeloma with hypercalcemia (corrected serum calcium ≥11 mg/dL or symptomatic): part of CRAB criteria; emergency when ≥14 mg/dL or symptomatic (altered mentation, AKI, arrhythmia)
Clinical directionhold
Categoryorgan-dysfunction
Shifts algorithmALGO-MM-1L

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "calcium_corrected_mg_dl",
      "threshold": 11
    },
    {
      "finding": "hypercalcemia_symptomatic",
      "value": true
    },
    {
      "comparator": ">=",
      "finding": "calcium_corrected_mg_dl",
      "threshold": 14
    }
  ],
  "type": "composite"
}

Notes

Hypercalcemia is one of CRAB criteria for MM diagnosis; per ESMO-MM 2023 + NCCN-MM: aggressive IV hydration (3-4 L NS/24h), zoledronic acid 4 mg IV (renal-adjusted) or denosumab 120 mg SC; calcitonin 4 IU/kg SC q12h for first 24-48h while bisphosphonate engages; corticosteroid (dex 40 mg) doubles as MM induction component. Direction HOLD on routine induction start until calcium <12 mg/dL and renal function baseline restored; priority 12. STUB — requires clinical co-lead signoff.

Used By

Indications