Hypocalcemia natural history, complications and prognosis
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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]
- 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).[8][9]
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.
- ↑ 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.