Hypocalcemia: Diff Dx
- Diff Dx:
- factitious levels 2nd to low protein and albumin (malabsorption, intestinal bypass surgery);
- causes related to calcium deficiency:
- osteomalacia (most common)
- vitamin D defficiency;
- both vitamin D deficient rickets and vitamin dependent rickets may cause hypocalcemia;
- vitamin D resistant rickets usually does not cause hypocalcemia;
- hypocalcemia can be caused by hypomagnesemia resulting from both an insufficient intake of magnesium and magnesium wasting owing to diarrhea and thiazide therapy;
- causes related to excess of phosphorous:
- nephrotic syndrome (phosphate retention-hyperphospatemia)
- phosphorus ingestion
- renal failure;
- tumor lysis
- massive tumor lysis results from the release of intracellular phosphate during massive cell destruction;
- commonly occurs during chemo for ALL in children;
- serum Pi levels typically rise within 1-2 days after initiating treatment;
- rising serum Pi concentration often is accompanied by hypocalcemia, hyperuricemia, hyperkalemia, and renal failure;
- medullary Ca of thyroid
- rhabdomyolysis (phosphate release);
- hypercalcemia may occur once the oliguric phase has ended;
- acute pancreatitis
- alkalosis, hyperventilation
- hypo K &/or HypoMg will potentiate hypoCa;
- loop diuretics
Significance of hypocalcemia following hypovolemic shock.
Parathyroid response to hypocalcemia after treatment of hemorrhagic shock.
Ionized calcium and magnesium: the effect of septic shock in the baboon.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Tuesday, September 4, 2012 3:33 pm