Diseases

Hypercalcemia

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Hypercalcaemia, also spelled hypercalcemia, is a high calcium (ca2+) level in the blood serum. The Normal range is 2.1–2.6 mmol/l (8.8–10.7 mg/dl, 4.3–5.2 meq/l) with levels greater than 2.6 mmol/l defined as hypercalcemia. Those With a mild increase that has developed slowly typically have no symptoms.

In those with greater levels or rapid onset, symptoms may include abdominal pain, bone pain, confusion, depression, weakness, kidney stones, or an abnormal heart rhythm including cardiac arrest.
Most cases are due to primary hyperparathyroidism or cancer.[1] other causes include sarcoidosis, tuberculosis, paget disease, multiple endocrine neoplasia (men), vitamin d toxicity, familial hypocalciuric hypercalcaemia, and certain medications such as lithium and hydrochlorothiazide.
Diagnosis should generally include either a corrected calcium or ionized calcium level and be confirmed after a week.Specific Changes, such as a shortened qt interval, may be seen on an electrocardiogram (ecg).
Symptoms : the neuromuscular symptoms of hypercalcemia are caused by a negative bathmotropic effect due to the increased interaction of calcium with sodium channels. Since calcium blocks sodium channels and inhibits depolarization of nerve and muscle fibers, increased calcium raises the threshold for depolarization. This results in diminished deep tendon reflexes(hyporeflexia), and skeletal muscle weakness. There Is a general mnemonic for remembering the effects of hypercalcaemia: "stones, bones, groans, thrones and psychiatric overtones"
stones (renal or biliary) (see calculus)
bones (bone pain)
groans (abdominal pain, nausea and vomiting)
thrones (polyuria) resulting in dehydration
psychiatric overtones (depression 30–40%, anxiety, cognitive dysfunction, insomnia, coma)