Hypocalcemia natural history, complications and prognosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
 
(32 intermediate revisions by 4 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Hypocalcemia}}
{{Hypocalcemia}}
Please help WikiDoc by adding content here. It's easy!  Click  [[Help:How_to_Edit_a_Page|here]] to learn about editing.
{{CMG}}; {{AE}} {{VKG}}
 
==Overview==
The clinical features of [[hypocalcemia]] may vary widely, and range from [[asymptomatic]] to life-threatening [[complications]].The main factors that influence [[serum]] [[calcium]] levels are [[parathyroid hormone]] ([[PTH]]), [[vitamin D]], ionized [[calcium]], and [[phosphate]]. [[Hypocalcemia]] is commonly encountered in patients who are hospitalized. Under treatment or improper treatment of hypocalcemic emergencies can lead to significant [[morbidity]]. Death is rare but has been reported in [[hypocalcemia]] patients.
 
==Natural History==
* The clinical presentation of hypocalcemia may vary widely and range from [[asymptomatic]] to life-threatening complications.<ref name="pmid21841146">{{cite journal |vauthors=Kelly A, Levine MA |title=Hypocalcemia in the critically ill patient |journal=J Intensive Care Med |volume=28 |issue=3 |pages=166–77 |date=2013 |pmid=21841146 |doi=10.1177/0885066611411543 |url=}}</ref>
* [[Parathyroid hormone]] ([[PTH]]), [[vitamin D]], ionized [[calcium]], and [[phosphate]] are the main regulators that influence [[serum]] [[calcium]] levels.<ref name="pmid231481472">{{cite journal |vauthors=Carroll R, Matfin G |title=Endocrine and metabolic emergencies: hypocalcaemia |journal=Ther Adv Endocrinol Metab |volume=1 |issue=1 |pages=29–33 |date=February 2010 |pmid=23148147 |pmc=3474611 |doi=10.1177/2042018810366494 |url=}}</ref><ref name="pmid25891861">{{cite journal |vauthors=Lee S, Mannstadt M, Guo J, Kim SM, Yi HS, Khatri A, Dean T, Okazaki M, Gardella TJ, Jüppner H |title=A Homozygous [Cys25]PTH(1-84) Mutation That Impairs PTH/PTHrP Receptor Activation Defines a Novel Form of Hypoparathyroidism |journal=J. Bone Miner. Res. |volume=30 |issue=10 |pages=1803–13 |date=October 2015 |pmid=25891861 |pmc=4580526 |doi=10.1002/jbmr.2532 |url=}}</ref><ref name="pmid8293350">{{cite journal |vauthors=Mizunashi K, Furukawa Y, Abe K, Yoshinaga K |title=The relationship between serum intact parathyroid hormone and calcium in idiopathic hypoparathyroidism |journal=Calcif. Tissue Int. |volume=53 |issue=6 |pages=378–83 |date=December 1993 |pmid=8293350 |doi= |url=}}</ref>
* As the people age the calcium requirement also increases and risk for calcium deficiency also increases by age.
* Poor [[calcium]] intake, certain medications, dietary intolerance, [[hormonal]] changes and [[genetic]] factors may lead to hypocalcemia.
 
==Complications==
* Common [[complications]] of hypocalcemia include<ref name="pmid23148147">{{cite journal |vauthors=Carroll R, Matfin G |title=Endocrine and metabolic emergencies: hypocalcaemia |journal=Ther Adv Endocrinol Metab |volume=1 |issue=1 |pages=29–33 |date=February 2010 |pmid=23148147 |pmc=3474611 |doi=10.1177/2042018810366494 |url=}}</ref><ref name="pmid9781172">{{cite journal |vauthors=Garabédian M |title=[Hypocalcemia] |language=French |journal=Rev Prat |volume=48 |issue=11 |pages=1201–6 |date=June 1998 |pmid=9781172 |doi= |url=}}</ref><ref name="pmid7808098">{{cite journal |vauthors=Reber PM, Heath H |title=Hypocalcemic emergencies |journal=Med. Clin. North Am. |volume=79 |issue=1 |pages=93–106 |date=January 1995 |pmid=7808098 |doi= |url=}}</ref><ref name="pmid2004255">{{cite journal |vauthors=Macefield G, Burke D |title=Paraesthesiae and tetany induced by voluntary hyperventilation. Increased excitability of human cutaneous and motor axons |journal=Brain |volume=114 ( Pt 1B) |issue= |pages=527–40 |date=February 1991 |pmid=2004255 |doi= |url=}}</ref><ref name="pmid26923551">{{cite journal |vauthors=Thurlow JS, Yuan CM |title=Dialysate-induced hypocalcemia presenting as acute intradialytic hypotension: A case report, safety review, and recommendations |journal=Hemodial Int |volume=20 |issue=2 |pages=E8–E11 |date=April 2016 |pmid=26923551 |doi=10.1111/hdi.12386 |url=}}</ref><ref name="pmid4014262">{{cite journal |vauthors=Levine SN, Rheams CN |title=Hypocalcemic heart failure |journal=Am. J. Med. |volume=78 |issue=6 Pt 1 |pages=1033–5 |date=June 1985 |pmid=4014262 |doi= |url=}}</ref><ref name="pmid2382615">{{cite journal |vauthors=Wong CK, Lau CP, Cheng CH, Leung WH, Freedman B |title=Hypocalcemic myocardial dysfunction: short- and long-term improvement with calcium replacement |journal=Am. Heart J. |volume=120 |issue=2 |pages=381–6 |date=August 1990 |pmid=2382615 |doi= |url=}}</ref><ref name="pmid1633370">{{cite journal |vauthors=Kudoh C, Tanaka S, Marusaki S, Takahashi N, Miyazaki Y, Yoshioka N, Hayashi M, Shimamoto K, Kikuchi K, Iimura O |title=Hypocalcemic cardiomyopathy in a patient with idiopathic hypoparathyroidism |journal=Intern. Med. |volume=31 |issue=4 |pages=561–8 |date=April 1992 |pmid=1633370 |doi= |url=}}</ref><ref name="pmid942827">{{cite journal |vauthors=Denlinger JK, Nahrwold ML |title=Cardiac failure associated with hypocalcemia |journal=Anesth. Analg. |volume=55 |issue=1 |pages=34–6 |date=1976 |pmid=942827 |doi= |url=}}</ref><ref name="pmid26015274">{{cite journal |vauthors=Brunelli SM, Sibbel S, Do TP, Cooper K, Bradbury BD |title=Facility Dialysate Calcium Practices and Clinical Outcomes Among Patients Receiving Hemodialysis: A Retrospective Observational Study |journal=Am. J. Kidney Dis. |volume=66 |issue=4 |pages=655–65 |date=October 2015 |pmid=26015274 |doi=10.1053/j.ajkd.2015.03.038 |url=}}</ref><ref name="pmid2632508">{{cite journal |vauthors=Gupta MM |title=Medical emergencies associated with disorders of calcium homeostasis |journal=J Assoc Physicians India |volume=37 |issue=10 |pages=629–31 |date=October 1989 |pmid=2632508 |doi= |url=}}</ref>
** [[Bone]] disease such as:
*** [[Osteoporosis]], complications from [[osteoporosis]] include
**** [[Fractures]] 
**** [[Disability]]
** [[Cardiovascular]] collapse with [[cardiac arrhythmia]]
*** The [[ECG]] hallmark of hypocalcaemia is prolongation of the [[corrected QT interval]].
** Hypocalcemic [[cardiomyopathy]]
** [[Hypotension]] which is unresponsive to fluids and [[vasopressors]]
** [[Dysrhythmias]]
** [[Laryngospasm]]
** [[Seizures]]
** [[Tetany]]
** [[Basal ganglia]] [[calcification]]
** [[Parkinsonism]]
** [[Hemiballismus]]
** [[Choreoathetosis]]
** Intradialytic hypotension
 
==Prognosis==
* [[Prognosis]] is generally good when [[hypocalcemia]] treated optimally.
* The [[Concentration|concentrations]] of [[ionized]] [[calcium]] on day 3 could be very useful for the [[prediction]] of [[mortality]] and [[disability]] in patients with moderate and severe [[Traumatic brain injury|traumatic brain injury]] ([[Traumatic brain injury|TBI]]).<ref name="pmid26396605">{{cite journal |vauthors=Manuel VR, Martin SA, Juan SR, Fernando MA, Frerk M, Thomas K, Christian H |title=Hypocalcemia as a prognostic factor in mortality and morbidity in moderate and severe traumatic brain injury |journal=Asian J Neurosurg |volume=10 |issue=3 |pages=190–4 |date=2015 |pmid=26396605 |pmc=4553730 |doi=10.4103/1793-5482.161171 |url=}}</ref><ref name="pmid24139087">{{cite journal |vauthors=Vinas-Rios JM, Sanchez-Aguilar M, Sanchez-Rodriguez JJ, Gonzalez-Aguirre D, Heinen C, Meyer F, Kretschmer T |title=Hypocalcaemia as a prognostic factor of early mortality in moderate and severe traumatic brain injury |journal=Neurol. Res. |volume=36 |issue=2 |pages=102–6 |date=February 2014 |pmid=24139087 |doi=10.1179/1743132813Y.0000000272 |url=}}</ref>


==References==
==References==
{{Reflist|2}}
{{reflist|2}}


[[Category:Needs content]]
[[Category:Needs content]]
[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Nephrology]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Nephrology]]
[[Category:Disease]]
[[Category:Emergency medicine]]
 
[[Category:Blood tests]]
{{WS}}
{{WH}}
{{WH}}
{{WS}}

Latest revision as of 11:53, 13 August 2018

Hypocalcemia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypocalcemia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypocalcemia natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypocalcemia natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypocalcemia natural history, complications and prognosis

CDC on Hypocalcemia natural history, complications and prognosis

Hypocalcemia natural history, complications and prognosis in the news

Blogs on Hypocalcemia natural history, complications and prognosis

Directions to Hospitals Treating Hypocalcemia

Risk calculators and risk factors for Hypocalcemia natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

The clinical features of hypocalcemia may vary widely, and range from asymptomatic to life-threatening complications.The main factors that influence serum calcium levels are parathyroid hormone (PTH), vitamin D, ionized calcium, and phosphate. Hypocalcemia is commonly encountered in patients who are hospitalized. Under treatment or improper treatment of hypocalcemic emergencies can lead to significant morbidity. Death is rare but has been reported in hypocalcemia patients.

Natural History

Complications

Prognosis

References

  1. Kelly A, Levine MA (2013). "Hypocalcemia in the critically ill patient". J Intensive Care Med. 28 (3): 166–77. doi:10.1177/0885066611411543. PMID 21841146.
  2. Carroll R, Matfin G (February 2010). "Endocrine and metabolic emergencies: hypocalcaemia". Ther Adv Endocrinol Metab. 1 (1): 29–33. doi:10.1177/2042018810366494. PMC 3474611. PMID 23148147.
  3. Lee S, Mannstadt M, Guo J, Kim SM, Yi HS, Khatri A, Dean T, Okazaki M, Gardella TJ, Jüppner H (October 2015). "A Homozygous [Cys25]PTH(1-84) Mutation That Impairs PTH/PTHrP Receptor Activation Defines a Novel Form of Hypoparathyroidism". J. Bone Miner. Res. 30 (10): 1803–13. doi:10.1002/jbmr.2532. PMC 4580526. PMID 25891861.
  4. Mizunashi K, Furukawa Y, Abe K, Yoshinaga K (December 1993). "The relationship between serum intact parathyroid hormone and calcium in idiopathic hypoparathyroidism". Calcif. Tissue Int. 53 (6): 378–83. PMID 8293350.
  5. Carroll R, Matfin G (February 2010). "Endocrine and metabolic emergencies: hypocalcaemia". Ther Adv Endocrinol Metab. 1 (1): 29–33. doi:10.1177/2042018810366494. PMC 3474611. PMID 23148147.
  6. Garabédian M (June 1998). "[Hypocalcemia]". Rev Prat (in French). 48 (11): 1201–6. PMID 9781172.
  7. Reber PM, Heath H (January 1995). "Hypocalcemic emergencies". Med. Clin. North Am. 79 (1): 93–106. PMID 7808098.
  8. Macefield G, Burke D (February 1991). "Paraesthesiae and tetany induced by voluntary hyperventilation. Increased excitability of human cutaneous and motor axons". Brain. 114 ( Pt 1B): 527–40. PMID 2004255.
  9. Thurlow JS, Yuan CM (April 2016). "Dialysate-induced hypocalcemia presenting as acute intradialytic hypotension: A case report, safety review, and recommendations". Hemodial Int. 20 (2): E8–E11. doi:10.1111/hdi.12386. PMID 26923551.
  10. Levine SN, Rheams CN (June 1985). "Hypocalcemic heart failure". Am. J. Med. 78 (6 Pt 1): 1033–5. PMID 4014262.
  11. Wong CK, Lau CP, Cheng CH, Leung WH, Freedman B (August 1990). "Hypocalcemic myocardial dysfunction: short- and long-term improvement with calcium replacement". Am. Heart J. 120 (2): 381–6. PMID 2382615.
  12. Kudoh C, Tanaka S, Marusaki S, Takahashi N, Miyazaki Y, Yoshioka N, Hayashi M, Shimamoto K, Kikuchi K, Iimura O (April 1992). "Hypocalcemic cardiomyopathy in a patient with idiopathic hypoparathyroidism". Intern. Med. 31 (4): 561–8. PMID 1633370.
  13. Denlinger JK, Nahrwold ML (1976). "Cardiac failure associated with hypocalcemia". Anesth. Analg. 55 (1): 34–6. PMID 942827.
  14. Brunelli SM, Sibbel S, Do TP, Cooper K, Bradbury BD (October 2015). "Facility Dialysate Calcium Practices and Clinical Outcomes Among Patients Receiving Hemodialysis: A Retrospective Observational Study". Am. J. Kidney Dis. 66 (4): 655–65. doi:10.1053/j.ajkd.2015.03.038. PMID 26015274.
  15. Gupta MM (October 1989). "Medical emergencies associated with disorders of calcium homeostasis". J Assoc Physicians India. 37 (10): 629–31. PMID 2632508.
  16. Manuel VR, Martin SA, Juan SR, Fernando MA, Frerk M, Thomas K, Christian H (2015). "Hypocalcemia as a prognostic factor in mortality and morbidity in moderate and severe traumatic brain injury". Asian J Neurosurg. 10 (3): 190–4. doi:10.4103/1793-5482.161171. PMC 4553730. PMID 26396605.
  17. Vinas-Rios JM, Sanchez-Aguilar M, Sanchez-Rodriguez JJ, Gonzalez-Aguirre D, Heinen C, Meyer F, Kretschmer T (February 2014). "Hypocalcaemia as a prognostic factor of early mortality in moderate and severe traumatic brain injury". Neurol. Res. 36 (2): 102–6. doi:10.1179/1743132813Y.0000000272. PMID 24139087.

Template:WS Template:WH