Myeloma Nurse Learning Programme Module 3 – Diagnosis of myeloma Hypercalcaemia

Hypercalcaemia

Myeloma bone disease causes the release of calcium from the bone into the circulation that can lead to hypercalcaemia. It is present at diagnosis in approximately 15% of patients and seen in up to 30% of patients at some point during the course of their myeloma.

Hypercalcaemia is usually associated with patients who have a large tumour burden. Symptoms and signs of hypercalcaemia include:

Lethargy
Polyuria
Constipation
Nausea and vomiting

However, hypercalcaemia that is not corrected can eventually lead to one or more of the following: 

Dehydration
Confusion
Orthostatic hypotension
Renal failure
Cardiac abnormalities

It is important therefore to be vigilant for symptoms associated with hypercalcaemia and to correct serum calcium levels as early as possible. Usually, intravenous fluid replacement or intravenous bisphosphonates to help reduce bone turnover are the treatments of choice.

Hypercalcaemia

Further reading