- Nausea and vomiting which are central effects of hypercalcaemia.
These may aggravate dehydration induced by polyuria - Peptic ulcer disease
- Pancreatitis
4- Nervous system
Nausea, vomiting, malaise, fatigue, and even psychosis are all
central effects of hypercalcaemia.
5- Tissue deposition of calcium may lead to nephrocalcinosis, vascular
calcification, pruritis, conjunctival calcification (red-eye) and band
keratopathy.
Treatment:
A- Treatment of the etiologic cause
B- Treatment of hypercalcaemia
1- Saline diuresis in patients with reasonable kidney function. If
there is no response we can inforce diuresis by furosemide and
intravenous saline. Loop diuretics in contrary to thiazide
diuretics increase urinary calcium excretion.
2- Glucocorticoids are effective in all conditions other than
hyperparathyroidism. In sarcoidosis and Vit. D intoxication 10
mg prednisolone may be sufficient while in malignancy doses
up to 60 mg/d may be required.
3- Others:
- Methramycin is particularly useful in malignancy related
hypercalcaemia, a dose of 20-30 ug/kg may induce fall in
serum Ca2+ within hours and last for few days. - Calcitonin 50-100 units S.C.
- Phosphate oral or intravenous, but carries the risk of
metastatic calcification.