Hypocalcemia natural history, complications and prognosis: Difference between revisions
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==Complications== | ==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> | * 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> | ||
** Bone disease like | ** Bone disease like | ||
*** Osteoporosis,Complications from osteoporosis include | *** Osteoporosis,Complications from osteoporosis include | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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Overview
The clinical features of hypocalcemia may vary widely, which ranges from asymptomatic symptoms to life-threatening complications.The main factors that influence the serum calcium levels are parathyroid hormone (PTH), vitamin D, the calcium ions, and phosphate.Hypocalcemia is commonly encountered in patients who are hospitalized. Undertreatment 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 vary widely, ranges from asymptomatic symptoms to life-threatening complications.[1]
- Parathyroid hormone (PTH), vitamin D, the calcium ions, and phosphate are the main regulators that influence the serum calcium levels.
- 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[2][3][4][5][6][7][8][9]
- Bone disease like
- Osteoporosis,Complications from osteoporosis include
- Fractures
- Disability
- Osteoporosis,Complications from osteoporosis include
- 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
- Bone disease like
Prognosis
- Prognosis is generally good when hypocalcemia treated accordingly.
- The 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 (TBI).[10][11]
References
- ↑ 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.
- ↑ 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.
- ↑ Garabédian M (June 1998). "[Hypocalcemia]". Rev Prat (in French). 48 (11): 1201–6. PMID 9781172.
- ↑ Reber PM, Heath H (January 1995). "Hypocalcemic emergencies". Med. Clin. North Am. 79 (1): 93–106. PMID 7808098.
- ↑ 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.
- ↑ 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.
- ↑ Levine SN, Rheams CN (June 1985). "Hypocalcemic heart failure". Am. J. Med. 78 (6 Pt 1): 1033–5. PMID 4014262.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.