Hypocalcemia history and symptoms: Difference between revisions
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==Overview== | ==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]] | 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== | ==History and Symptoms== | ||
The majority of patients with mild [[hypocalcemia]] are [[asymptomatic]] | |||
===Common Symptoms=== | ===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> | 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> | ||
'''Neuromuscular | '''Neuromuscular symptoms''' | ||
* [[Tetany]]: which is [[hallmark]] of acute [[hypocalcemia]] | * [[Tetany]]: which is [[hallmark]] of acute [[hypocalcemia]] | ||
* [[Paresthesia|Paresthesias]] or [[tingling]] | * [[Paresthesia|Paresthesias]] or [[tingling]] | ||
* | * [[Muscle spasm|Muscle spasms]]: [[Muscle]] [[twitching]] and [[cramping]] | ||
* [[Laryngeal]] or [[bronchial]] [[spasm]] | * [[Laryngeal]] or [[bronchial]] [[spasm]] | ||
====Central | ====Central nervous system s'''ymptoms''' ==== | ||
* [[Anxiety]] | * [[Anxiety]] | ||
* [[Hallucination|Hallucinations]] | * [[Hallucination|Hallucinations]] | ||
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* [[Irritability]] | * [[Irritability]] | ||
====Cardiovascular ''' | ====Cardiovascular s'''ymptoms''' ==== | ||
* [[Bradycardia]] | * [[Bradycardia]] | ||
* [[Ventricular]] [[arrhythmias]] | * [[Ventricular]] [[arrhythmias]] | ||
* [[Congestive heart failure]] | * [[Congestive heart failure]] | ||
==== | ==== Pulmonary s'''ymptoms''' ==== | ||
* [[Laryngeal]] [[stridor]] | * [[Laryngeal]] [[stridor]] | ||
* [[Bronchospasm]] | * [[Bronchospasm]] | ||
==== Less | ==== Less common symptoms ==== | ||
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> | 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> | ||
* [[Cognitive]] deficits | * [[Cognitive]] deficits | ||
* [[Extrapyramidal symptom|Extrapyramidal]] symptoms | * [[Extrapyramidal symptom|Extrapyramidal]] symptoms | ||
Latest revision as of 11:56, 13 August 2018
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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
- Tetany: which is hallmark of acute hypocalcemia
- Paresthesias or tingling
- Muscle spasms: Muscle twitching and cramping
Central nervous system symptoms
Cardiovascular symptoms
Pulmonary symptoms
Less common symptoms
Less common symptoms of hypocalcemia include[5]
- Cognitive deficits
- Extrapyramidal symptoms
- Dermatitis
- Dry skin
- Brittle nails
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.