Hypocalcemia Diagnosis in the Surgical Environment.
Main Article Content
Abstract
Hypocalcemia, characterized by a total serum calcium level below 8.5 mg/dL (corrected for albumin) or an ionized serum calcium level below 4.65 mg/dL, presents a spectrum of clinical manifestations ranging from asymptomatic to life-threatening. Common after neck procedures, early detection and appropriate management are essential. Diagnostic tools include assessing calcium levels, correcting for albumin, and determining the underlying cause through tests like intact parathyroid hormone, serum phosphorus, magnesium, and creatinine. Treatment involves calcium replacement and addressing the root cause, with potential complications such as neuromuscular excitability and cardiac arrhythmias. Prognosis varies based on severity and underlying factors, emphasizing the importance of avoiding diagnostic pitfalls and overtreatment in chronic cases. ECG and genetic testing contribute to accurate diagnosis, aiding in differentiating causes like autosomal dominant hypocalcemia. Recognizing factitious hypocalcemia related to hypoalbuminemia or binding protein alterations is crucial. Understanding the pH-calcium relationship guides clinical evaluation. Holistic management requires a collaborative approach, emphasizing patient engagement and follow-up care.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Hakami, Y., & Khan, A. (2019). Hypoparathyroidism. Parathyroid Disorders, 51, 109-126.
II. Goltzman, D., Rosen, C., & Mulder, J. (2013). Etiology of hypocalcemia in adults. UpToDate, Waltham, MA.(Accessed on April 13, 2014).
III. Pepe, J., Colangelo, L., Biamonte, F., Sonato, C., Danese, V. C., Cecchetti, V., ... & Cipriani, C. (2020). Diagnosis and management of hypocalcemia. Endocrine, 69, 485-495.
IV. Aul, A. J., Fischer, P. R., O'Grady, J. S., Mara, K. C., Maxson, J. A., Meek, A. M., ... & Thacher, T. D. (2019). Population-based incidence of potentially life-threatening complications of hypocalcemia and the role of vitamin D deficiency. The Journal of pediatrics, 211, 98-104.
V. Schafer, A. L., & Shoback, D. M. (2015). Hypocalcemia: diagnosis and treatment.
VI. Rosa, K. M., Matos, L. L. D., Cernea, C. R., Brandão, L. G., & Araújo Filho, V. J. F. D. (2015). Postoperative calcium levels as a diagnostic measure for hypoparathyroidism after total thyroidectomy. Archives of endocrinology and metabolism, 59, 428-433.
VII. Cooper, M. S., & Gittoes, N. J. (2008). Diagnosis and management of hypocalcaemia. Bmj, 336(7656), 1298-1302.
VIII. Vakharia, J. D., & Topor, L. S. (2021). Hypocalcemia. Endocrine Conditions in Pediatrics: A Practical Guide, 29-38.
IX. Kelly, A., & Levine, M. A. (2013). Hypocalcemia in the critically ill patient. Journal of intensive care medicine, 28(3), 166-177.
X. Prins, A. (2010). Nutritional assessment of the critically ill patient. South African Journal of Clinical Nutrition, 23(1), 11-18.
XI. Clase, C. M., Norman, G. L., Beecroft, M. L., & Churchill, D. N. (2000). Albumin‐corrected calcium and ionized calcium in stable haemodialysis patients. Nephrology Dialysis Transplantation, 15(11), 1841-1846.
XII. Meng, Q. H., & Wagar, E. A. (2015). Laboratory approaches for the diagnosis and assessment of hypercalcemia. Critical reviews in clinical laboratory sciences, 52(3), 107-119.
XIII. Asmar, A., Mohandas, R., & Wingo, C. S. (2012). A physiologic-based approach to the treatment of a patient with hypokalemia. American journal of kidney diseases, 60(3), 492-497.
XIV. Deyrup, A. T., D'Ambrosio, D., Muir, J., Deyrup, A., Knollmann-Ritschel, B., Scordino, T., ... & Lin, A. (2022). Essential laboratory tests for medical education. Academic pathology, 9(1), 100046.
XV. Schattner, A., Dubin, I., Huber, R., & Gelber, M. (2016). Hypocalcaemia of malignancy. Neth J Med, 74(6), 231-239.
XVI. Abate, E. G., & Clarke, B. L. (2017). Review of hypoparathyroidism. Frontiers in endocrinology, 7, 172.
XVII. 17. Roszko, K. L., Stapleton Smith, L. M., Sridhar, A. V., Roberts, M. S., Hartley, I. R., Gafni, R. I., ... & Nemeth, E. F. (2022). Autosomal dominant hypocalcemia type 1: A systematic review. Journal of Bone and Mineral Research, 37(10), 1926-1935.