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Also known as: high calcium · hypercalcemia
Raised serum calcium — remembered as 'stones, bones, groans and psychiatric moans' (renal stones, bone pain, abdominal/constipation, confusion). Most cases are primary hyperparathyroidism or malignancy.
Primary hyperparathyroidism (commonest outpatient cause) and malignancy (bone metastases, PTHrP, myeloma — commonest inpatient cause); also granulomatous disease (TB/sarcoidosis), vitamin D excess, thiazides and immobilisation.
First step in significant hypercalcaemia
Caution: Watch for fluid overload in cardiac/renal impairment.
Malignant hypercalcaemia (after rehydration)
Caution: Bisphosphonate acts over days; dose-adjust in renal impairment.
Guidelines change. If something here is out of date, tell us — we keep these current.
🚩 Report outdated / suggest update