Hypocalcemia | |
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Specialty | Endocrinology |
Symptoms | Numbness, muscle spasms, seizures, confusion[1][2] |
Complications | Cardiac arrest[1][2] |
Causes | Hypoparathyroidism, vitamin D deficiency, kidney failure, pancreatitis, calcium channel blocker overdose, rhabdomyolysis, tumor lysis syndrome, bisphosphonates[1][2] |
Diagnostic method | Blood serum < 2.1 mmol/L (corrected calcium or ionized calcium)[1][2][3] |
Treatment | Calcium supplements, vitamin D, magnesium sulfate.[1][2] |
Frequency | ~18% of people in hospital[4] |
Hypocalcemia is a medical condition characterized by low calcium levels in the blood serum.[5] The normal range of blood calcium is typically between 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), while levels less than 2.1 mmol/L are defined as hypocalcemic.[1][3][6] Mildly low levels that develop slowly often have no symptoms.[2][4] Otherwise symptoms may include numbness, muscle spasms, seizures, confusion, or in extreme cases cardiac arrest.[1][2]
The most common cause for hypocalcemia is iatrogenic hypoparathyroidism.[2] Other causes include other forms of hypoparathyroidism, vitamin D deficiency, kidney failure, pancreatitis, calcium channel blocker overdose, rhabdomyolysis, tumor lysis syndrome, and medications such as bisphosphonates or denosumab.[1] Diagnosis should generally be confirmed by determining the corrected calcium or ionized calcium level.[2] Specific changes may also be seen on an electrocardiogram (ECG).[1]
Initial treatment for severe disease is with intravenous calcium chloride and possibly magnesium sulfate.[1] Other treatments may include vitamin D, magnesium, and calcium supplements.[2] If due to hypoparathyroidism, hydrochlorothiazide, phosphate binders, and a low salt diet may also be recommended.[2] About 18% of people who are being treated in hospital have hypocalcemia.[4]
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