Pediatric emergency medicine trisk 2872 2872
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TABLE 100.10
CAUSES OF HYPOCALCEMIA
Precipitation or altered binding
Hyperphosphatemia
Metabolic alkalosis
Citrated products
Pancreatitis
Vitamin D deficiency
Nutritional
Malabsorption
Impaired synthesis
Hepatic dysfunction
Renal dysfunction
Impaired metabolism
Vitamin D–dependent rickets
Hypoparathyroidism
Impaired synthesis
DiGeorge syndrome
Activating mutations of the calcium-sensing receptor
Pseudohypoparathyroidism
Other
Hypomagnesemia
Hungry bone syndrome
Fluoride poisoning
Clinical manifestations. The clinical manifestations of hypocalcemia are
dependent on the severity of the abnormality, the rate of decline in serum
calcium, and the chronicity of the underlying process. Other factors
affecting the development of symptoms include acid–base balance and
hypomagnesemia. Classic acute manifestations of hypocalcemia include
neuromuscular instability or tetany, which affects both sensory and
muscular function. Early or mild symptoms include paresthesias of the
perioral region, hands and feet, and muscle cramps. More severe symptoms
include seizure, laryngospasm, and bronchospasm. Classic physical
