Hypocalcaemia (2)

Question 1

What is it?

Why’s it important for Ca levels to be adjusted to Albumin?

What are its causes?

How does it present?

Answer 1

➊ Serum Ca < 2.1 mmol/L

➋ Hypoalbuminaemia may cause apparant hypocalcaemia

➌ • Hypoparathyroidism
• Vit D deficiency
• Hypomagnesaemia
• Acute pancreatitis
• Malabsorption
• Hypomagnesaemia

➍ SPASMODIC:
• Spasms - Trousseau’s sign (arm)
• Perioral paraesthesia
• Anxiety, irritability
• Seizures
• Muscle tone increase (colic, dysphagia)
• Orientation impairment (confusion)
• Dermatitis
• Impetigo herpetiformis
• Chvostek’s sign (face)

Question 2

What are the investigations to do?

How is it acutely managed?

How is it managed long-term?

Answer 2

➊ • ECG - Prolonged QT interval, Osborn wave
• Bloods - PTH, Vit D, Mg, Amylase
• Bone profile - Ca, pH, Albumin, ALP

➋ • Mild - PO Calcium Carbonate
• Severe (Spasms/ECG changes) - IV Calcium Gluconate

➌ • Treat underlying cause
• Improve dietary intake
• Supplementation