Many people are asymptomatic especially when they have mild hypercalcaemia` (1).
Features of hypercalcaemia may include (the mnemonic “Stones, bones, abdominal moans, and psychic groans,” can be used :
- GIT problems “abdominal moans”:
- constipation
- nausea and vomiting
- peptic ulceration - due to increased gastrin secretion
- abdominal pain
- pancreatitis (1)
- psychological:
- depression is common
- dementia and psychoses occur infrequently
- renal “stones”:
- polyuria due to a decreased sensitivity to antidiuretic hormone
- compensatory polydipsia
- nephrolithiasis
- nephrocalcinosis (1)
- skeleton “bones”:
- bone pain
- arthritis
- osteoporosis (1)
- neuromuscular “psychic groans”:
- lethargy and fatigue
- weakness
- anorexia
- impaired concentration and memory (1)
- calcification:
- cornea
- conjunctival flare
- urolithiasis
- less commonly, chondrocalcinosis
- cardiovascular
- hypertension
- shortened QT interval on electrocardiogram (1)
In severe hypercalcaemia (total calcium > 3.5 mmol per l):
- cardiac arrhythmias
- renal tubular damage - hypokalaemia, dehydration, sodium loss; renal vasoconstriction; acute renal failure
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