Hypocalcemia resident survival guide

Hypocalcemia Resident Survival Guide
Diagnostic Criteria
Causes
Focused Initial Rapid Evaluation
Complete Diagnostic Approach
Dos
Don'ts

Main article: Hypocalcemia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Zaghw, M.D. [2]; Vidit Bhargava, M.B.B.S [3]

Overview

Diagnostic Criteria

• Hypocalcemia is defined as corrected serrum total calcium level <2.12mmol/L.

Causes

Common

• Surgery induced hypoparathyroidism.

• Autoimmune disease induced hypoparathyroidism.
• Renal disease.
• Malabsorption induced vitamin D deficiency.
• Vitamin D deficiency due to low dietary intake or exposure to ultraviolet light.

Rare=

• Hypomagnesaemia.
• Vitamin D resistance.
• Sclerotic metastasis.
• Parathyroid hormone resistance.
• Autosomal dominant hypocalcemia.

Others=

• Critical illness.
• Hungry bone syndrome after parathyroidectomy for hyperparathyroidism.
• Post high dose IV treatment with bisphosphonates in vitamin D deficient patients.
• Infusion of phosphates or calcium chelators, such as citrate, with massive blood transfusion.
• Fanconi syndrome.

• Post irradiation of parathyroid gland.

• Pseudohypoparathyroidism.

FIRE: Focused Initial Rapid Evaluation

Focused Initial Rapid Evaluation (FIRE) should be undertaken to identify patients requiring urgent intervention.

Abbreviations:

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Complete Diagnostic Approach

Dos

Don'ts

References