Overview
Hypercalcaemia describes an increased serum calcium concentration. Two main conditions cause hypercalcaemia (up to 90%):
- Primary hyperparathyroidism
- Malignancy
Causes
- Primary hyperparathyroidism – most common:
- Usually seen in postmenopausal women
- Malignancy
- Vitamin D overdose
- Excess calcium intake
- Hyperthyroidism
- Granulomatous disease (e.g. tuberculosis and sarcoidosis)
- Paget’s disease of bone
- Thiazide diuretics
Presentation
Features can be remembered using the following mnemonic:
- Bones – bone pain and fractures
- Stones – renal stones
- Abdominal groans – anorexia, nausea
- Psychiatric moans – depression, insomnia, impaired memory
- Thrones – constipation
- An ECG may show QT interval shortening
Management
- 1st-line: IV normal saline + manage the underlying cause
Complications
- Renal stones
- Features of hypercalcaemia (e.g. depression, constipation, nausea)
- Arrhythmia
