Hypocalcemia classification: Difference between revisions
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==Overview== | ==Overview== | ||
Hypocalcemia may be classified functionally into complete absence of [[parathyroid gland]], [[parathyroid hormone]] ([[PTH]]) insufficiency and [[Parathyroid hormone|PTH]] overactivity. | |||
==Classification== | ==Classification== | ||
* [[Hypocalcemia]] may be classified functionally into following | * [[Hypocalcemia]] may be classified functionally into the following sub-types: | ||
==== Absence of | ==== Absence of parathyroid gland ==== | ||
* Absence of PTH is primarily seen in<ref name="pmid19923405">{{cite journal |vauthors=Riccardi D, Brown EM |title=Physiology and pathophysiology of the calcium-sensing receptor in the kidney |journal=Am. J. Physiol. Renal Physiol. |volume=298 |issue=3 |pages=F485–99 |date=March 2010 |pmid=19923405 |pmc=2838589 |doi=10.1152/ajprenal.00608.2009 |url=}}</ref><ref name="pmid23087872">{{cite journal |vauthors=Sarkar S, Mondal M, Das K, Shrimal A |title=Mucocutaneous manifestations of acquired hypoparathyroidism: An observational study |journal=Indian J Endocrinol Metab |volume=16 |issue=5 |pages=819–20 |date=September 2012 |pmid=23087872 |pmc=3475912 |doi=10.4103/2230-8210.100637 |url=}}</ref><ref name="pmid12678507">{{cite journal |vauthors=Sturniolo G, Lo Schiavo MG, Tonante A, D'Alia C, Bonanno L |title=Hypocalcemia and hypoparathyroidism after total thyroidectomy: a clinical biological study and surgical considerations |journal=Int. J. Surg. Investig. |volume=2 |issue=2 |pages=99–105 |date=2000 |pmid=12678507 |doi= |url=}}</ref><ref name="pmid9606288">{{cite journal |vauthors=Pattou F, Combemale F, Fabre S, Carnaille B, Decoulx M, Wemeau JL, Racadot A, Proye C |title=Hypocalcemia following thyroid surgery: incidence and prediction of outcome |journal=World J Surg |volume=22 |issue=7 |pages=718–24 |date=July 1998 |pmid=9606288 |doi= |url=}}</ref><ref name="pmid171470832">{{cite journal |vauthors=Sciumè C, Geraci G, Pisello F, Facella T, Li Volsi F, Licata A, Modica G |title=[Complications in thyroid surgery: symptomatic post-operative hypoparathyroidism incidence, surgical technique, and treatment] |language=Italian |journal=Ann Ital Chir |volume=77 |issue=2 |pages=115–22 |date=2006 |pmid=17147083 |doi= |url=}}</ref> | * Absence of PTH is primarily seen in<ref name="pmid19923405">{{cite journal |vauthors=Riccardi D, Brown EM |title=Physiology and pathophysiology of the calcium-sensing receptor in the kidney |journal=Am. J. Physiol. Renal Physiol. |volume=298 |issue=3 |pages=F485–99 |date=March 2010 |pmid=19923405 |pmc=2838589 |doi=10.1152/ajprenal.00608.2009 |url=}}</ref><ref name="pmid23087872">{{cite journal |vauthors=Sarkar S, Mondal M, Das K, Shrimal A |title=Mucocutaneous manifestations of acquired hypoparathyroidism: An observational study |journal=Indian J Endocrinol Metab |volume=16 |issue=5 |pages=819–20 |date=September 2012 |pmid=23087872 |pmc=3475912 |doi=10.4103/2230-8210.100637 |url=}}</ref><ref name="pmid12678507">{{cite journal |vauthors=Sturniolo G, Lo Schiavo MG, Tonante A, D'Alia C, Bonanno L |title=Hypocalcemia and hypoparathyroidism after total thyroidectomy: a clinical biological study and surgical considerations |journal=Int. J. Surg. Investig. |volume=2 |issue=2 |pages=99–105 |date=2000 |pmid=12678507 |doi= |url=}}</ref><ref name="pmid9606288">{{cite journal |vauthors=Pattou F, Combemale F, Fabre S, Carnaille B, Decoulx M, Wemeau JL, Racadot A, Proye C |title=Hypocalcemia following thyroid surgery: incidence and prediction of outcome |journal=World J Surg |volume=22 |issue=7 |pages=718–24 |date=July 1998 |pmid=9606288 |doi= |url=}}</ref><ref name="pmid171470832">{{cite journal |vauthors=Sciumè C, Geraci G, Pisello F, Facella T, Li Volsi F, Licata A, Modica G |title=[Complications in thyroid surgery: symptomatic post-operative hypoparathyroidism incidence, surgical technique, and treatment] |language=Italian |journal=Ann Ital Chir |volume=77 |issue=2 |pages=115–22 |date=2006 |pmid=17147083 |doi= |url=}}</ref> | ||
** Hereditary [[hypoparathyroidism]] | ** Hereditary [[hypoparathyroidism]] | ||
** Acquired [[hypoparathyroidism]] | ** Acquired [[hypoparathyroidism]] (e.g. surgical resection) | ||
** [[Hypomagnesemia]] | ** [[Hypomagnesemia]] | ||
==== PTH | ==== PTH insufficiency ==== | ||
* [[Parathyroid hormone|PTH]] insufficiency is seen | * [[Parathyroid hormone|PTH]] insufficiency is seen when the active form of [[vitamin D]] ([[1,25-dihydroxy vitamin D|1,25 di-Hydroxy-Vitamin D]] or [[Vitamin D3]]) is lacking. This may be seen in<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="pmid3592447">{{cite journal |vauthors=Zaloga GP, Chernow B |title=The multifactorial basis for hypocalcemia during sepsis. Studies of the parathyroid hormone-vitamin D axis |journal=Ann. Intern. Med. |volume=107 |issue=1 |pages=36–41 |date=July 1987 |pmid=3592447 |doi= |url=}}</ref> | ||
** | ** Reduced dietary intake of [[vitamin D]] | ||
** Insufficient exposure to [[sunlight]] | ** Insufficient exposure to [[sunlight]] | ||
** [[Vitamin D]]-dependent rickets type 1 | ** [[Vitamin D]]-dependent [[rickets]] type 1 | ||
** [[Chronic renal failure]] | ** [[Chronic renal failure]] | ||
* [[Parathyroid hormone|PTH]] insufficiency is seen in active [[vitamin D]] ineffectiveness which is seen in | * [[Parathyroid hormone|PTH]] insufficiency is seen in active [[vitamin D]] ineffectiveness which is seen in | ||
** [[Intestinal malabsorption]] | ** [[Intestinal malabsorption]] | ||
** [[Vitamin D]]-dependent rickets type 2 | ** [[Vitamin D]]-dependent rickets type 2 | ||
** | ** [[Pseudohypoparathyroidism]] | ||
==== PTH | ==== PTH overactivity ==== | ||
* [[Parathyroid hormone|PTH]] overactivity | * [[Parathyroid hormone|PTH]] overactivity is seen in<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="BrunelliGoldfarb2007">{{cite journal|last1=Brunelli|first1=S. M.|last2=Goldfarb|first2=S.|title=Hypophosphatemia: Clinical Consequences and Management|journal=Journal of the American Society of Nephrology|volume=18|issue=7|year=2007|pages=1999–2003|issn=1046-6673|doi=10.1681/ASN.2007020143}}</ref> | ||
** Severe [[hypophosphatemia]] | ** Severe [[hypophosphatemia]] | ||
** Tumor | ** [[Tumor lysis syndrome]] | ||
** [[Acute renal failure]] | ** [[Acute renal failure]] | ||
** [[Rhabdomyolysis]] | ** [[Rhabdomyolysis]] | ||
Latest revision as of 18:20, 10 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]Vindhya BellamKonda, M.B.B.S [3]
Overview
Hypocalcemia may be classified functionally into complete absence of parathyroid gland, parathyroid hormone (PTH) insufficiency and PTH overactivity.
Classification
- Hypocalcemia may be classified functionally into the following sub-types:
Absence of parathyroid gland
- Absence of PTH is primarily seen in[1][2][3][4][5]
- Hereditary hypoparathyroidism
- Acquired hypoparathyroidism (e.g. surgical resection)
- Hypomagnesemia
PTH insufficiency
- PTH insufficiency is seen when the active form of vitamin D (1,25 di-Hydroxy-Vitamin D or Vitamin D3) is lacking. This may be seen in[6][7]
- Reduced dietary intake of vitamin D
- Insufficient exposure to sunlight
- Vitamin D-dependent rickets type 1
- Chronic renal failure
- PTH insufficiency is seen in active vitamin D ineffectiveness which is seen in
- Intestinal malabsorption
- Vitamin D-dependent rickets type 2
- Pseudohypoparathyroidism
PTH overactivity
References
- ↑ Riccardi D, Brown EM (March 2010). "Physiology and pathophysiology of the calcium-sensing receptor in the kidney". Am. J. Physiol. Renal Physiol. 298 (3): F485–99. doi:10.1152/ajprenal.00608.2009. PMC 2838589. PMID 19923405.
- ↑ Sarkar S, Mondal M, Das K, Shrimal A (September 2012). "Mucocutaneous manifestations of acquired hypoparathyroidism: An observational study". Indian J Endocrinol Metab. 16 (5): 819–20. doi:10.4103/2230-8210.100637. PMC 3475912. PMID 23087872.
- ↑ Sturniolo G, Lo Schiavo MG, Tonante A, D'Alia C, Bonanno L (2000). "Hypocalcemia and hypoparathyroidism after total thyroidectomy: a clinical biological study and surgical considerations". Int. J. Surg. Investig. 2 (2): 99–105. PMID 12678507.
- ↑ Pattou F, Combemale F, Fabre S, Carnaille B, Decoulx M, Wemeau JL, Racadot A, Proye C (July 1998). "Hypocalcemia following thyroid surgery: incidence and prediction of outcome". World J Surg. 22 (7): 718–24. PMID 9606288.
- ↑ Sciumè C, Geraci G, Pisello F, Facella T, Li Volsi F, Licata A, Modica G (2006). "[Complications in thyroid surgery: symptomatic post-operative hypoparathyroidism incidence, surgical technique, and treatment]". Ann Ital Chir (in Italian). 77 (2): 115–22. PMID 17147083.
- ↑ 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.
- ↑ Zaloga GP, Chernow B (July 1987). "The multifactorial basis for hypocalcemia during sepsis. Studies of the parathyroid hormone-vitamin D axis". Ann. Intern. Med. 107 (1): 36–41. PMID 3592447.
- ↑ 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.
- ↑ Brunelli, S. M.; Goldfarb, S. (2007). "Hypophosphatemia: Clinical Consequences and Management". Journal of the American Society of Nephrology. 18 (7): 1999–2003. doi:10.1681/ASN.2007020143. ISSN 1046-6673.