Hypercalcemia history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
History and Symptoms
The symptoms of hypercalcemia are same irrespective of etiology. Neurological symptoms are common in hypercalcemia as normal neurological processes requires optimal serum extracellular concentration.[1]
History
Although majority of patients with hypercalcemia have non-specific history but a detailed and thorough history from the patient is necessary. The patient may have a positive history of:[2]
- Kidney stones
- Bone pain and tenderness
- Fragile bones of the limbs and spine that can break easily
- Frequent and excessive urination
- Gastrointestinal symptoms like epigastric pain, constipation, indigestion, nausea, and vomiting
- Feeling tired, ill, and weak
- Depression and memory disturbances
- Vitamin D deficiency
- Chronic renal failure in case secondary hyperparathyroidism is suspected
- Renal transplant in case tertiary hyperparathyroidism is suspected
- Use of medications including thiazide diuretics and lithium.
- Neck radiation
Symptoms
"Bones, stones, groans, and psychic moans" is a saying which will help you remember the signs and symptoms of hypercalcemia; if it is chronic it can result in urinary calculi (renal stones or bladder stones). Abnormal heart rhythms can result, and EKG findings of a short QT interval and a widened T wave suggest hypercalcemia.[3]
Symptoms are more common at high calcium blood values (12.0 mg/dL or 3 mmol/l). Severe hypercalcemia (above 15-16 mg/dL or 3.75-4 mmol/l) is considered a medical emergency: at these levels, coma and cardiac arrest can result.
Hypercalcemia per se can result in:[4]
Complete List of Possible Symptoms
- Renal stones
- Headaches
- Bone pain and/or weakness
- Abdominal pain
- Confusion
- Nausea/vomiting
- Constipation
- Peptic ulcer disease
- Hallucinations
- Bradycardia
- Insulin resistance
- Glucose intolerance
- Muscle weakness
- Hyporeflexia
- Polyuria
- Shortened QT interval
- Pancreatitis
- Psychosis
- Depression
- Anxiety
- Constipation
- Decreased libido
- Hypertension
- Heart palpitations which are often due to bouts of atrial fibrillation
- Gastroesophageal reflux
- Lack of concentration
- Loss of appetite
- Left ventricular hypertrophy
- Polydipsia
- Thinning of hair
References
- ↑ Iacovelli E, Gilio F, Mascia ML, Scillitani A, Romagnoli E, Pichiorri F; et al. (2011). "Acute and chronic effects of hypercalcaemia on cortical excitability as studied by 5 Hz repetitive transcranial magnetic stimulation". J Physiol. 589 (Pt 7): 1619–26. doi:10.1113/jphysiol.2010.201111. PMC 3099019. PMID 21300754.
- ↑ Silverberg SJ, Bilezikian JP (1996). "Evaluation and management of primary hyperparathyroidism" (PDF). J. Clin. Endocrinol. Metab. 81 (6): 2036–40. doi:10.1210/jcem.81.6.8964825. PMID 8964825.
- ↑ Elaraj DM, Clark OH (2008). "Current status and treatment of primary hyperparathyroidism". Perm J. 12 (1): 32–7. PMC 3042336. PMID 21369510.
- ↑ Silverberg SJ, Bilezikian JP (1996). "Evaluation and management of primary hyperparathyroidism" (PDF). J. Clin. Endocrinol. Metab. 81 (6): 2036–40. doi:10.1210/jcem.81.6.8964825. PMID 8964825.