hipokalsemi

Hypocalcemia, or hipocalcemia in some languages, is a condition characterized by low levels of calcium in the blood. In adults, total serum calcium is typically considered low below about 8.5 mg/dL (2.12 mmol/L), with ionized calcium below roughly 1.12 mmol/L also regarded as deficient. Because total calcium depends on albumin, a corrected calcium calculation is often used when albumin is abnormal.

Causes and pathophysiology vary and include hypoparathyroidism, vitamin D deficiency or resistance, chronic kidney disease with phosphate retention, pancreatitis, malabsorption, and magnesium deficiency. Certain medications (for example loop diuretics or citrate-containing blood products) or acute illness can also precipitate hypocalcemia. In critically ill patients or after major surgery, transient hypocalcemia is common. Alkalosis and severe illnesses can further shift calcium into the bone and tissues.

Clinical features range from none to life-threatening. Mild cases may be asymptomatic or present with numbness and tingling around the mouth or in the extremities. More significant deficiency can cause muscle cramps, tetany, Chvostek sign, and Trousseau sign, as well as seizures or arrhythmias. Severe hypocalcemia may progress to laryngospasm or cardiac issues and requires urgent evaluation.

Diagnosis involves measuring serum calcium, adjusting for albumin when needed, and preferably assessing ionized calcium. Additional tests may include magnesium, phosphate, parathyroid hormone, and vitamin D levels to determine the cause.

Treatment depends on severity. Acute, symptomatic hypocalcemia is treated with intravenous calcium, typically calcium gluconate, with continuous monitoring. Chronic management includes oral calcium supplements, often with active vitamin D (calcitriol), and correcting any magnesium deficiency. Addressing the underlying cause is essential.

Prognosis varies with etiology and response to therapy. With appropriate treatment, most patients stabilize, but recurrence is common if the underlying disorder is not controlled.