Physical examination of patients with familial hypocalciuric hypercalcemia (FHH) is usually unremarkable. Very rarely patients may have examination findings due to hypercalcemia.

• Physical examination of patients with FHH is usually unremarkable.^[1]
• Patients may have physical examination findings due to hypercalcemia.^[2]

• Patients with FHH usually have a normal appearance.

• Patients with hypercalcemia may have:
  • High blood pressure due to hypercalcemia

• Patients with hypercalcemia may have:
  • Band keratopathy (calcium precipitation in a horizontal band across the cornea in the palpebral aperture); may lead to vision impairment

• Patients with hypercalcemia may have cardiovascular symptoms such as:
  • Palpitations due to arrhythmias
  • Shortened QT interval
  • Chest pain due to fluid overload form renal failure
  • Rales and S3 due to fluid overload form renal failure

• Patients with hypercalcemia may have:
  • Nausea and vomiting
  • Anorexia
  • constipation
  • Epigastric pain and tenderness due to development of pancreatitis
  • Flank pain and tenderness due to nephrolithiasis

• Patients with severe hypercalcemia may have:
  • Alteration in urinary habits
  • Volume depletion
  • Signs of renal failure

• The patient is usually oriented to person, place, and time.
• Patients with severe hypercalcemia may have:
  • Anxiety
  • Fatigue and weakness
  • Lethargy
  • Sleep disturbances
  • Muscle twitch and cramps
  • Signs of depression
  • Confusion
  • Memory disturbances
  • Hypotonia
  • Hyporeflexia

• Normal