Hypocalcemia causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Causes
Common Causes
Hypocalcemia can be the consequence of multiple disease processes, some of which will be mentioned in the following discussion. The most common cause is the inability to mobilize calcium from bone which is primarily induced by decreased levels of the parathyroid hormone (PTH) due to derangement of the parathyroid gland function (ie, the gland responsible of calcium homeostasis) or vitamin D deficiency.
- Hypoparathyroidism: It signifies diminished activity of the parathyroid gland due to multiple reasons: autoimmune destruction (included in the polyglandular autoimmune syndrome type I), resection of the glands as a possible complication of total thyroidectomy or genetic diseases affecting the gland's function. A second entity that should be mentioned is pseudohypoparathyroidism which is characterized by normal gland function but inability of the PTH-target organs (bone and kidney) to respond to PTH. Patients present with hypocalcemia but high PTH levels.
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical / poisoning | Alcohol abuse |
| Dermatologic | No underlying causes |
| Drug Side Effect | Anticonvulsant therapy, Chelation therapy, Diuretic therapy, Drugs, Enemas, laxatives, Steroid therapy |
| Ear Nose Throat | No underlying causes |
| Endocrine | Absent parathyroid hormone (PTH), Acquired hypoparathyroidism, Adrenocortical hyperplasia, Deficient PTH, Excessive secretion of calcitonin, Familial hypocalcemia, Following thyroidectomy, Hereditary hypoparathyroidism, "Hungry Bone Syndrome" following parathyroidectomy, Hypoparathyroidism, Hypoproteinemia, Medullary carcinoma of the thyroid, Osteitis fibrosa following parathyroidectomy, Osteoporosis, Pseudohypoparathyroidism, Thyroid cancer |
| Environmental | Decreased ultraviolet/sun (vitamin D deficiency), Defective Vitamin D metabolism, Exposure to hydrofluoric acid |
| Gastroenterologic | Acute pancreatitis, Cirrhosis, Decreased dietary intake, Eating disorders, Enemas, laxatives, Intestinal malabsorption, Malabsorption, Maldigestion, Pancreatitis, Rickets, Short bowel syndrome, Vitamin-D dependent rickets, type I |
| Genetic | DiGeorge's Syndrome, Familial hypocalcemia |
| Hematologic | Hypoalbuminemia (pseudohypocalcemia), Transfusion of citrated blood, Tumor lysis syndrome |
| Iatrogenic | No underlying causes |
| Infectious Disease | Sepsis, Septic shock |
| Musculoskeletal / Ortho | Enhanced bone formation, Excessive secretion of calcitonin, Neonatal tetany, Osteitis fibrosa following parathyroidectomy, Osteoporosis, Rickets, Vitamin-D dependent rickets, type I |
| Neurologic | No underlying causes |
| Nutritional / Metabolic | Absent active vitamin D, Decreased dietary intake, Hyperphosphatemia, Intestinal malabsorption, Intravenous phosphate administration, Magnesium depletion, Rickets, Vitamin D deficiency |
| Obstetric/Gynecologic | Breast cancer |
| Oncologic | Breast cancer, Bronchial cancer, Medullary carcinoma of the thyroid, Osteoblastic metastases, Thyroid cancer, Tumor lysis syndrome |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | Magnesium over supplementation, Prolonged use of medications/laxatives containing magnesium |
| Psychiatric | Eating disorders |
| Pulmonary | Bronchial cancer, Hyperventilation |
| Renal / Electrolyte | Acute renal failure, Alkalosis, Chronic renal failure, Hypomagnesemia, Hypoproteinemia, Increased diuresis with physiologic saline solution, Intravenous phosphate administration, Kidney diseases with reduced formation of activated vitamin D, Magnesium depletion, Magnesium over supplementation, Nephrotic syndrome, Renal failure, Rhabdomyolysis, Severe acute hyperphosphatemia |
| Rheum / Immune / Allergy | DiGeorge's Syndrome, Osteitis fibrosa following parathyroidectomy, Polyglandular autoimmune syndrome |
| Sexual | No underlying causes |
| Trauma | Burns |
| Urologic | Acute renal failure, Chronic renal failure, Hypoproteinemia, Renal failure |
| Miscellaneous | Postoperative, Transfusion of citrated blood |
Causes in Alphabetical Order