Hypocalcemia: Differential Analysis of Causes

by Carlo Raj, MD

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    Let’s take a look at important differentials of hypocalcemia. To begin with, let’s say that your patient began with having primary hypoparathyroidism and there was surgery that was done that we talked about earlier in which you remove too much parathyroid and may result in hypoparathyroidism. Now, you have decreased reabsorption of calcium, thus resulting in hypocalcemia. We’ll talk about psedohypoparathyroidism in great detail. In other words, this is PTH resistance. Be careful, I am not referring to PTH related peptide here. Vitamin D deficiency, for whatever reason, and an inadequate oral intake. Now, what you will find to be interesting with Vitamin D deficiency is the fact that, remember, we had a discussion of secondary hypoparathyroidism and the most common cause of Vitamin D deficiency in the United Sates is renal failure. Now, a patient with renal failure is experiencing hypocalcemia. Malabsorption could be a cause; end stage liver or kidney disease for reasons we just talked about. Inadequate production or inadequate synthesis of calcitriol; liver, kidney in order; may manifest as osteomalacia, obviously referring to an adult who is deficient of Vitamin D due to these organ injuries. Large blood transfusion, citrate is important for you to pay attention to in transfused blood can bind to calcium therefore, resulting in or rendering the patient hypocalcemic. Remember, you need free ionized calcium for you to have proper functioning. If any point in time calcium is bound excessively, your patient is considered to be hypocalcemic. Magnesium dep-depletion is important, decreased in PTH release… magnesium depletion. Three major times that you want to keep in mind - may result in the possible clinical manifestations of seizures, long QT syndrome and hypomagnesemia with decreased PTH release and therefore, as a consequence, hypocalcemia. Also, any time that there is an increased alkalotic state,...

    About the Lecture

    The lecture Hypocalcemia: Differential Analysis of Causes by Carlo Raj, MD is from the course Parathyroid Gland Disorders.

    Included Quiz Questions

    1. Vitamin D deficiency
    2. Hypoparathyroidism
    3. Decreased oral intake
    4. Malabsorption
    5. Increased citrate levels
    1. Albumin
    2. Citrate
    3. Vitamin D
    4. Magnesium
    5. Free fatty acids
    1. Phosphate
    2. Magnesium
    3. Free fatty acids
    4. Albumin
    5. Vitamin D

    Author of lecture Hypocalcemia: Differential Analysis of Causes

     Carlo Raj, MD

    Carlo Raj, MD

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