Skip to Main Content


  • • Elevated serum calcium


Symptoms and Signs


  • • Fatigability

    • Muscle weakness

    • Depression

    • Anorexia

    • Nausea

    • Constipation

    • Polyuria

    • Polydipsia

    • Metastatic calcification

    • Coma


Laboratory Findings


  • • Elevated serum calcium


  • • Hyperparathyroidism

    • Cancer with bone metastases

    • Ectopic parathyroid hormone (PTH) production

    • Vitamin D intoxication

    • Hyperthyroidsm

    • Milk-alkali syndrome

    • Prolonged immobilization

    • Thiazide diuretics

    • Addison disease

    • Familial Hypocalciuric hypercalcemia (FHH)


  • • Physical exam

    • Measure PTH

    • Elevated or non-suppressed PTH with elevated calcium implies primary hyperparathyroidism

    • Suppressed PTH implies normal parathyroid function; most common diagnosis is malignancy

    • Mild elevation of PTH and calcium can by FHH


  • • If severe (> 14.5 mg/dL), IV isotonic saline to decrease serum calcium by dilution and diuresis

    • Lasix

    • IV sodium sulfate

    • Plicamycin is useful to treat those with metastatic cancer

    • Corticosteroids for sarcoidosis, vitamin D intoxication, and Addison disease

    • Calcitonin can be useful for patients with impaired renal or cardiac function who might not tolerate forced diuresis

    • Hemodialysis in renal failure

    • Operative correction for hyperparathyroidism

    • No therapy needed for FHH



Body JJ. Current and future directions in medical therapy: Hypercalcemia. Cancer. 2000;88(12 Suppl):3054.
Ziegler R. Hypercalcemic crisis. J Am Soc Nephrol. 2001;12(Suppl 17):S3.
Shepard MM. Smith JW 3rd. Hypercalcemia. American Journal of the Medical Sciences. 2007, 334(5):381-5.  [PubMed: 18004092]

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.