Hypocalcemia history and symptoms: Difference between revisions

Jump to navigation Jump to search
mNo edit summary
No edit summary
 
(11 intermediate revisions by 3 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Hypocalcemia}}
{{Hypocalcemia}}
{{CMG}}
{{CMG}}; {{AE}} {{MKK}}


==Overview==
==Overview==
Clinical presentation of hypocalcemia reflects the serum level of ionized calcium and depends on the severity of any concurrent [[electrolyte imbalance]].<ref>{{cite book | last = Taal | first = Maarten | title = Brenner & Rector's the kidney | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2012 | isbn = 978-1416061939 }}</ref><ref>{{cite book | last = Johnson | first = Richard | title = Comprehensive clinical nephrology | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455758388 }}</ref> Overt symptoms occur when ionized calcium falls below 3.2 mg/dL (0.8 mmol/L).<ref>{{cite book | last = Schaider | first = Jeffrey | title = Rosen & Barkin's 5-minute emergency medicine consult | publisher = Lippincott Williams & Wilkins | location = Philadelphia | year = 2011 | isbn = 978-1608316304 }}</ref>
Clinical presentation of [[hypocalcemia]] reflects the [[serum]] level of [[ionized]] [[calcium]] and depends on the severity of any concurrent [[electrolyte imbalance]]. Overt [[symptoms]] occur when ionized [[calcium]] falls below 3.2 mg/dL (0.8 mmol/L). An abrupt fall in the [[serum]] [[calcium]] level typically manifests as [[neuromuscular]] hyperexcitability in the form of [[tetany]] and [[tingling]].  Patients who develop hypocalcemia gradually may be asymptomatic. In addition to [[fatigue]] and [[muscle weakness]], longstanding hypocalcemia is usually associated with [[neuropsychiatric]] [[symptoms]].


An abrupt fall in the serum calcium level typically manifests as neuromuscular excitability in the form of [[tetany]] and [[tingling]].  Patients who develop hypocalcemia gradually may be asymptomatic.
==History and Symptoms==
The majority of patients with mild [[hypocalcemia]] are [[asymptomatic]]


In addition to [[fatigue]] and [[muscle weakness]], longstanding hypocalcemia is usually associated with neuropsychiatric symptoms.<ref>{{Cite journal| doi = 10.1136/bmj.39582.589433.BE| issn = 1756-1833| volume = 336| issue = 7656| pages = 1298–1302| last1 = Cooper| first1 = Mark S.| last2 = Gittoes| first2 = Neil J. L.| title = Diagnosis and management of hypocalcaemia| journal = BMJ (Clinical research ed.)| date = 2008-06-07| pmid = 18535072| pmc = PMC2413335}}</ref>
===Common Symptoms===
Common symptoms of [[hypocalcemia]] include:<ref>{{Cite journal| doi = 10.1136/bmj.39582.589433.BE| issn = 1756-1833| volume = 336| issue = 7656| pages = 1298–1302| last1 = Cooper| first1 = Mark S.| last2 = Gittoes| first2 = Neil J. L.| title = Diagnosis and management of hypocalcaemia| journal = BMJ (Clinical research ed.)| date = 2008-06-07| pmid = 18535072| pmc = PMC2413335}}</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="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="pmid18535072">{{cite journal |vauthors=Cooper MS, Gittoes NJ |title=Diagnosis and management of hypocalcaemia |journal=BMJ |volume=336 |issue=7656 |pages=1298–302 |date=June 2008 |pmid=18535072 |pmc=2413335 |doi=10.1136/bmj.39582.589433.BE |url=}}</ref>


==History and Symptoms==
'''Neuromuscular symptoms'''
* [[Tetany]]: which is [[hallmark]] of acute [[hypocalcemia]]
* [[Paresthesia|Paresthesias]] or [[tingling]]
* [[Muscle spasm|Muscle spasms]]: [[Muscle]] [[twitching]] and [[cramping]]


===Symptoms===
* [[Laryngeal]] or [[bronchial]] [[spasm]]


====Neuromuscular Excitability====
====Central nervous system s'''ymptoms'''  ====
* [[Laryngeal]] or [[bronchial]] [[spasm]]
* [[Anxiety]]
* [[Muscle]] [[twitching]] and [[cramping]]
* [[Hallucination|Hallucinations]]
* [[Muscle weakness]]
* [[Confusion]]
* Circumoral and extremity [[paresthesia]] or [[tingling]]
* [[Irritability]]


====Central Nervous System Features====
====Cardiovascular s'''ymptoms''' ====
* [[Fatigue]]
* [[Bradycardia]]
* [[Ventricular]] [[arrhythmias]]
* [[Congestive heart failure]]


* [[Altered mental status]]
==== Pulmonary s'''ymptoms''' ====
* Emotional disturbance (eg, [[irritability]], [[depression]], [[psychosis]])
* [[Laryngeal]] [[stridor]]
* [[Seizure]]
* [[Bronchospasm]]


====Cardiovascular Features====
==== Less common symptoms ====
* Symptoms of [[hypotension]]
Less common [[symptoms]] of [[hypocalcemia]] include<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>
* Symptoms of [[congestive heart failure]]
* [[Cognitive]] deficits
* [[Extrapyramidal symptom|Extrapyramidal]] symptoms
* [[Dermatitis]]
* Dry skin
* [[Brittle nails|Brittle]] nails


==References==
==References==
Line 38: Line 49:
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category:Emergency medicine]]
 
[[Category:Blood tests]]
{{WS}}
{{WH}}

Latest revision as of 11:56, 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 history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypocalcemia history and symptoms

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypocalcemia history and symptoms

CDC on Hypocalcemia history and symptoms

Hypocalcemia history and symptoms in the news

Blogs on Hypocalcemia history and symptoms

Directions to Hospitals Treating Hypocalcemia

Risk calculators and risk factors for Hypocalcemia history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

Clinical presentation of hypocalcemia reflects the serum level of ionized calcium and depends on the severity of any concurrent electrolyte imbalance. Overt symptoms occur when ionized calcium falls below 3.2 mg/dL (0.8 mmol/L). An abrupt fall in the serum calcium level typically manifests as neuromuscular hyperexcitability in the form of tetany and tingling. Patients who develop hypocalcemia gradually may be asymptomatic. In addition to fatigue and muscle weakness, longstanding hypocalcemia is usually associated with neuropsychiatric symptoms.

History and Symptoms

The majority of patients with mild hypocalcemia are asymptomatic

Common Symptoms

Common symptoms of hypocalcemia include:[1][2][3][4]

Neuromuscular symptoms

Central nervous system symptoms

Cardiovascular symptoms

Pulmonary symptoms

Less common symptoms

Less common symptoms of hypocalcemia include[5]

References

  1. Cooper, Mark S.; Gittoes, Neil J. L. (2008-06-07). "Diagnosis and management of hypocalcaemia". BMJ (Clinical research ed.). 336 (7656): 1298–1302. doi:10.1136/bmj.39582.589433.BE. ISSN 1756-1833. PMC 2413335. PMID 18535072.
  2. 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.
  3. 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.
  4. Cooper MS, Gittoes NJ (June 2008). "Diagnosis and management of hypocalcaemia". BMJ. 336 (7656): 1298–302. doi:10.1136/bmj.39582.589433.BE. PMC 2413335. PMID 18535072.
  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.

Template:WS Template:WH