Hypocalcemia history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
Clinical presentation of hypocalcemia reflects the serum level of ionized calcium and depends on the severity of any concurrent [[electrolyte imbalance]].<ref>{{cite book | last = Taal | first = Maarten | title = Brenner & Rector's the kidney | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2012 | isbn = 978-1416061939 }}</ref><ref>{{cite book | last = Johnson | first = Richard | title = Comprehensive clinical nephrology | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455758388 }}</ref> Overt symptoms occur when ionized calcium falls below 3.2 mg/dL (0.8 mmol/L).<ref>{{cite book | last = Schaider | first = Jeffrey | title = Rosen & Barkin's 5-minute emergency medicine consult | publisher = Lippincott Williams & Wilkins | location = Philadelphia | year = 2011 | isbn = 978-1608316304 }}</ref> | Clinical presentation of [[hypocalcemia]] reflects the serum level of [[ionized]] [[calcium]] and depends on the severity of any concurrent [[electrolyte imbalance]].<ref>{{cite book | last = Taal | first = Maarten | title = Brenner & Rector's the kidney | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2012 | isbn = 978-1416061939 }}</ref><ref>{{cite book | last = Johnson | first = Richard | title = Comprehensive clinical nephrology | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455758388 }}</ref> Overt symptoms occur when ionized [[calcium]] falls below 3.2 mg/dL (0.8 mmol/L).<ref>{{cite book | last = Schaider | first = Jeffrey | title = Rosen & Barkin's 5-minute emergency medicine consult | publisher = Lippincott Williams & Wilkins | location = Philadelphia | year = 2011 | isbn = 978-1608316304 }}</ref> | ||
An abrupt fall in the serum calcium level typically manifests as neuromuscular excitability in the form of [[tetany]] and [[tingling]]. Patients who develop hypocalcemia gradually may be asymptomatic. | An abrupt fall in the [[serum]] calcium level typically manifests as [[neuromuscular]] excitability in the form of [[tetany]] and [[tingling]]. Patients who develop hypocalcemia gradually may be asymptomatic. | ||
In addition to [[fatigue]] and [[muscle weakness]], longstanding hypocalcemia is usually associated with neuropsychiatric symptoms.<ref>{{Cite journal| doi = 10.1136/bmj.39582.589433.BE| issn = 1756-1833| volume = 336| issue = 7656| pages = 1298–1302| last1 = Cooper| first1 = Mark S.| last2 = Gittoes| first2 = Neil J. L.| title = Diagnosis and management of hypocalcaemia| journal = BMJ (Clinical research ed.)| date = 2008-06-07| pmid = 18535072| pmc = PMC2413335}}</ref> | In addition to [[fatigue]] and [[muscle weakness]], longstanding hypocalcemia is usually associated with [[neuropsychiatric]] symptoms.<ref>{{Cite journal| doi = 10.1136/bmj.39582.589433.BE| issn = 1756-1833| volume = 336| issue = 7656| pages = 1298–1302| last1 = Cooper| first1 = Mark S.| last2 = Gittoes| first2 = Neil J. L.| title = Diagnosis and management of hypocalcaemia| journal = BMJ (Clinical research ed.)| date = 2008-06-07| pmid = 18535072| pmc = PMC2413335}}</ref> | ||
==History and Symptoms== | ==History and Symptoms== | ||
===Symptoms=== | * The majority of patients with mild [[hypocalcemia]] are [[asymptomatic]] | ||
===Common Symptoms=== | |||
Common symptoms of [[hypocalcemia]] include: | |||
'''Neuromuscular Excitability''' | |||
* [[Tetany]]: which is [[hallmark]] of acute [[hypocalcemia]] | |||
* [[Paresthesia|Paresthesias]] or [[tingling]] | |||
* Muscle [[Spasm|spasms]]: [[Muscle]] [[twitching]] and [[cramping]] | |||
* [[Laryngeal]] or [[bronchial]] [[spasm]] | * [[Laryngeal]] or [[bronchial]] [[spasm]] | ||
====Central Nervous System Features==== | ====Central Nervous System Features==== | ||
* [[ | * [[Anxiety]] | ||
* | * [[Hallucination|Hallucinations]] | ||
* [[ | * [[Confusion]] | ||
* [[Irritability]] | |||
====Cardiovascular Features==== | ====Cardiovascular Features==== | ||
* | * [[Bradycardia]] | ||
* | * [[Ventricular]] [[arrhythmias]] | ||
* [[Congestive heart failure]] | |||
==== Pulmonary ==== | |||
* [[Laryngeal]] [[stridor]] | |||
* [[Bronchospasm]] | |||
=== | ==== Less Common Symptoms ==== | ||
* [[ | Less common symptoms of [[hypocalcemia]] include | ||
* [[ | * [[Cognitive]] deficits | ||
* [[Extrapyramidal symptom|Extrapyramidal]] symptoms | |||
* [[Dermatitis]] | |||
* Dry skin | |||
* [[Brittle nails|Brittle]] nails | |||
==References== | ==References== |
Revision as of 19:31, 27 June 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Clinical presentation of hypocalcemia reflects the serum level of ionized calcium and depends on the severity of any concurrent electrolyte imbalance.[1][2] Overt symptoms occur when ionized calcium falls below 3.2 mg/dL (0.8 mmol/L).[3]
An abrupt fall in the serum calcium level typically manifests as neuromuscular excitability in the form of tetany and tingling. Patients who develop hypocalcemia gradually may be asymptomatic.
In addition to fatigue and muscle weakness, longstanding hypocalcemia is usually associated with neuropsychiatric symptoms.[4]
History and Symptoms
- The majority of patients with mild hypocalcemia are asymptomatic
Common Symptoms
Common symptoms of hypocalcemia include:
Neuromuscular Excitability
- Tetany: which is hallmark of acute hypocalcemia
- Paresthesias or tingling
- Muscle spasms: Muscle twitching and cramping
Central Nervous System Features
Cardiovascular Features
Pulmonary
Less Common Symptoms
Less common symptoms of hypocalcemia include
- Cognitive deficits
- Extrapyramidal symptoms
- Dermatitis
- Dry skin
- Brittle nails
References
- ↑ Taal, Maarten (2012). Brenner & Rector's the kidney. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1416061939.
- ↑ Johnson, Richard (2015). Comprehensive clinical nephrology. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455758388.
- ↑ Schaider, Jeffrey (2011). Rosen & Barkin's 5-minute emergency medicine consult. Philadelphia: Lippincott Williams & Wilkins. ISBN 978-1608316304.
- ↑ Cooper, Mark S.; Gittoes, Neil J. L. (2008-06-07). "Diagnosis and management of hypocalcaemia". BMJ (Clinical research ed.). 336 (7656): 1298–1302. doi:10.1136/bmj.39582.589433.BE. ISSN 1756-1833. PMC 2413335. PMID 18535072.