Hypocalcaemia, hypoparathyroidism and vitamin D deficiency

Extract

• Hypocalcaemia is diagnosed by measuring the concentration of serum ionized calcium or plasma albumin-corrected calcium.
  • Mild pseudohypocalcaemia due to albumin deficiency is often associated with severe illness and malnutrition. When plasma albumin decreases by 10 g/l, plasma calcium decreases by 0.2 mmol/l. This explains the mild, asymptomatic decrease in total plasma calcium associated with these conditions.
  • Plasma albumin-corrected calcium is suitable as an initial test, but if accurate calcium concentration is required for diagnostics or acute situations, serum ionized calcium should be measured.
• The main regulators of calcium levels are parathyroid hormone (PTH), vitamin D, phosphate and the fibroblast growth factor FGF-23, which regulates phosphate metabolism. Medication can also cause hypocalcaemia.
• Treatment of acute, severe hypocalcaemia (muscle spasm, laryngeal stridor, seizure, ventricular arrhythmias), requires calcium gluconate infusion.
• Long-term management of hypoparathyroidism should aim for calcium levels at the lower end of the reference range.

Read full article of Hypocalcaemia, hypoparathyroidism and vitamin D deficiency

Search terms

Aged, Albumins, Alkaline Phosphatase, Carbamazepine, Chvostek's sign, Diet, Dihydrotachysterol, E20*, E55*, E83.51, E89.2, Endocrinology, Hypocalcemia, Hypoparathyroidism, Internal medicine, Kidney Failure, Osteomalacia, Parathyroid Glands, Parathyroid Hormone, Phenytoin, Phosphates, Renal Insufficiency, Trousseau's test, Vitamin D Deficiency, calcium deficiency, pseudohypocalcemia