Hypercalcemia

Clinical presentation of hypercalcemia

Type Clinical features 
Mild hypercalcemia  (< 12 mg/dL) 
  • Can be asymptomatic 
  • Possible nonspecific symptoms 
    • Constipation 
    • Depression 
    • Fatigue 
Moderate hypercalcemia  (12-14 mg/dL) 
  • Neuropsychiatric 
    • Anxiety 
    • Cognitive dysfunction 
    • Depression 
  • GI 
    • Anorexia 
    • Constipation 
    • Nausea 
  • Renal 
    • Polyuria and polydipsia 
      • Due to nephrogenic diabetes insipidus 
    • Nephrolithiasis due to hypercalciuria 
    • Possible distal (Type 1) RTA 
  • Cardiac 
    • Shortened QTc interval on EKG 
  • Musculoskeletal 
    • Bone pain 
    • Osteoporosis 
    • Possible muscle weakness 
Severe hypercalcemia  (> 14 mg/dL) 
  • Neuropsychiatric 
    • Coma 
    • Confusion 
    • Lethargy 
    • Stupor 
  • Renal 
    • Chronic kidney disease 
    • Tubular necrosis  
  • Cardiac 
    • Calcifications in coronary arteries and heart valves 
    • Cardiomyopathy 
    • Hypertension 
  • Can have progression of symptoms in moderate hypercalcemia 
(Next Lesson) Causes of hypercalcemia
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