Hypercalcaemia

"Bones, Stones, Abdo Groans & Moans"

Si&Sy
GI - Anorexia, N&V, Abdo pain & Constipation, Peptic ulceration & Acute pancreatitis
Renal - Polyuria & polydipsia, calculi & nephrocalcinosis, renal failure
CVS - HTN, heart arrhythmias
MSK - weakness, lassitude
Eyes - corneal calcification
Mental changes
Underlying Disease

Causes
*
1ry HPTH (1/1000)
Malignancy (*myeloma)
- Bony mets
- Tumour - PTH related peptide
- Tumour - HCa agonists
Other
Sarcoidosis (increased calcitriol synth)
Vit D intox
3ry HPTH (eg CRF - post Tx)
Immobilisation (Paget's, Adolescents)
Thyrotoxicosis (severe)
Tz diuretics
Familial hypocalciuric HCa (v rare)

HCa + supp PTH = non-PTH Cause
HCa + raised/detectable PTH = PTH-mediated cause