Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e >Fluids and Electrolytes

Judith E. Tintinalli, J. Stephan Stapczynski, O. John Ma, Donald M. Yealy, Garth D. Meckler, David M. Cline+
TABLE 17-24Some Causes of Hypocalcemia

Cause Mechanism

Decreased calcium absorption

Vitamin D deficiency

Decreased oral intake Malnutrition

Decreased intestinal absorption Intestinal bypass, gastrectomy

Decreased production of 25(OH)D3 Liver failure

Decreased synthesis of 1,25(OH2)D3 Renal failure, hyperphosphatemia

Malabsorption syndromes

Increased calcium excretion/reduced bone resorption

Alcoholism Hypomagnesemia causing inhibition of PTH secretion, PTH resistance to bone resorption

Hypoparathyroidism Genetic, autoimmune, surgical, tumoral

Pseudohypoparathyroidism Resistance to PTH action

Hypomagnesemia Inhibition of PTH secretion, PTH resistance to bone resorption

Drugs (Table 17-25)

Miscellaneous

Sepsis

Acute pancreatitis Fatty acids combine with [Ca2+] to form insoluble Ca2+ soaps and lead to a reduction of serum [Ca2+]

Massive transfusions

Rhabdomyolysis

Abbreviations: 25(OH)D3 = 25-hydroxyvitamin D3; 1,25(OH2)D3 = 1,25-dihydroxyvitamin D3; PTH = parathyroid hormone.

Date of download: 03/26/23 from AccessEmergency Medicine: accessemergencymedicine.mhmedical.com, Copyright © McGraw Hill. All rights reserved.