Clinical features

Usually become apparent when total (ionised and un-ionised) plasma levels >3.5 mmol/l (normal range 2.2-2.6 mmol/l). Symptoms depend on the patient's age, the duration and rate of increase of plasma calcium, and the presence of concurrent medical conditions.

• Nausea, vomiting, weight loss, pruritus

• Muscle weakness, fatigue, lethargy

• Depression, mania, psychosis

• Drowsiness, coma

• Abdominal pain, constipation

• Acute pancreatitis

• Peptic ulceration

• Polyuria, renal calculi, renal failure

• Arrhythmias

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