Symptoms to Diagnosis

Severe hypercalcemia in a 54-year-old woman

Michael A. Munoz, MD, Zeeshan Zafar, MD, MBA and Benson A. Babu, MD, MBA
Cleveland Clinic Journal of Medicine November 2019, 86 (11) 719-723; DOI: https://doi.org/10.3949/ccjm.86a.18126

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Tables

  • TABLE 1

    Initial treatment of hypercalcemia

    SeveritySerum calcium level (mg/dL)Treatment
    Mild10.2–12.0Stop causative medications and encourage oral hydration
    Moderate12.0–14.0Start intravenous (IV) normal saline at maintenance dose if symptoms have been present without resolution
    Severe> 14.0Start IV normal saline at maintenance dose, consider combined calcitonin and bisphosphonate therapy If no improvement, consider denosumab or a glucocorticoid
    Very severe> 18.0Consider dialysis in patients with worsening renal failure or neurologic symptoms (or both)
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