Hypocalcemia
Other names	Hypocalcemia
Calcium within the periodic table
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	< 2.1 mmol/L corrected calcium [1] [2] [3] < 1.05 mmol/L ionized calcium [4]
Treatment	Calcium supplements, vitamin D, magnesium sulfate. [1] [2]
Frequency	~18% of people in hospital [5]

Hypocalcaemia is low calcium levels in the blood serum. ^[6] The normal range is 2.1–2.6  mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L) with levels less than 2.1 mmol/l defined as low. ^{[1] [3] [7]} Mildly low levels that develop slowly often have no symptoms. ^{[2] [5]} Otherwise symptoms may include numbness, muscle spasms, seizures, confusion, or cardiac arrest. ^{[1] [2]}

Common causes include hypoparathyroidism and vitamin D deficiency. ^[2] Others causes include kidney failure, pancreatitis, calcium channel blocker overdose, rhabdomyolysis, tumor lysis syndrome, and medications such as bisphosphonates. ^[1] Diagnosis should generally be confirmed with a corrected calcium or ionized calcium level. ^[2] A low ionized calcium is less than 1.05 mmol/L (4.5 mg/dL). ^[4] Specific changes may 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. ^[5]

References