Hypocalcemia laboratory findings: Difference between revisions
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Other laboratory tests include serum alkaline phosphates, liver function tests, coagulation profile, blood urea nitrogen, creatinine and urinary cAMP levels at baseline and after PTH administration. | Other laboratory tests include serum alkaline phosphates, liver function tests, coagulation profile, blood urea nitrogen, creatinine and urinary cAMP levels at baseline and after PTH administration. | ||
==Adjustment for Hypoalbuminemia== | |||
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* Adjustment of total serum calcium concentration for changes in plasma albumin level:<ref>{{Cite journal| issn = 0007-1447| volume = 1| issue = 6061| pages = 598| title = Correcting the calcium| journal = British Medical Journal| date = 1977-03-05| pmid = 843828| pmc = PMC1605322}}</ref> | * Adjustment of total serum calcium concentration for changes in plasma albumin level:<ref>{{Cite journal| issn = 0007-1447| volume = 1| issue = 6061| pages = 598| title = Correcting the calcium| journal = British Medical Journal| date = 1977-03-05| pmid = 843828| pmc = PMC1605322}}</ref> | ||
: ''Adjusted total calcium in mg/dL = Total calcium in mg/dL + 0.8 * (4 - Albumin in g/dL)'' | : ''Adjusted total calcium in mg/dL = Total calcium in mg/dL + 0.8 * (4 - Albumin in g/dL)'' | ||
: ''Adjusted total calcium in mmol/L = Total calcium in mmol/L + 0.02 * (40 - Albumin in g/L)'' | : ''Adjusted total calcium in mmol/L = Total calcium in mmol/L + 0.02 * (40 - Albumin in g/L)'' | ||
==Laboratory Differential Diagnosis of Hypocalcemia== | ==Laboratory Differential Diagnosis of Hypocalcemia== | ||
<span style="font-size: 85%;"> | <span style="font-size: 85%;"> | ||
'''Abbreviations''': | '''Abbreviations''': |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: hypocalcaemia; low serum calcium level
Overview
Laboratory investigations that detect alterations in PTH, vitamin D, and electrolytes in the serum or urine aids in the differential diagnosis of the underlying etiologies.
Measurement of the serum albumin concentration is essential to distinguish pseudohypocalcemia from true hypocalcemia.
Other laboratory tests include serum alkaline phosphates, liver function tests, coagulation profile, blood urea nitrogen, creatinine and urinary cAMP levels at baseline and after PTH administration.
Adjustment for Hypoalbuminemia
- Adjustment of total serum calcium concentration for changes in plasma albumin level:[1]
- Adjusted total calcium in mg/dL = Total calcium in mg/dL + 0.8 * (4 - Albumin in g/dL)
- Adjusted total calcium in mmol/L = Total calcium in mmol/L + 0.02 * (40 - Albumin in g/L)
Laboratory Differential Diagnosis of Hypocalcemia
Abbreviations: ADHP, autosomal dominant hypoparathyroidism; cAMP, cyclic adenosine monophosphate; CKD, chronic kidney disease; Cr, creatinine; Def, deficiency; HP, hyperphosphatemia; HPTH, hypoparathyroidism; PHP, pseudohypoparathyroidism; VDDR, vitamin D-dependent rickets.
↓Ca | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
↑PTH | ↔↓PTH | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
↑PO4 | ↔↓PO4 | ↔Mg | ↓Mg | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
↑Cr | ↔Cr | ↓25(OH)D | ↔↑25(OH)D | HPTH | ADHP or Mg def | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
CKD | PHP or HP | Vitamin D def | ↓1,25(OH)2D | ↑1,25(OH)2D | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Type I VDDR | Type II VDDR | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||