This can be broadly classified as being:

Parathyroid hormone related: primary hyperparathyroidism; secondary hyperparathyroidism in chronic renal insufficiency; tertiary hyperpara-thyroidism; ectopic PTH secretion.

Vitamin D related: vitamin D toxicity; granulomatous diseases associated with excess 1,25-dihydroxyvitamin D3 production.

Malignancy: increased osteoclastic activity due to bone destruction by primary or metastatic tumour; PTH-related protein or peptide.

Medications: thiazide diuretics; lithium; vitamin A and analogues.

Endocrine disorders: thyrotoxicosis; adrenocortical insufficiency.

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