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Clinical features of hypercalcaemia

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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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