Hypocalcemia

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Classification according to ICD-10
E83.5 Disorders of calcium metabolism
e58 Alimentary calcium deficiency
P71.0 Newborn cow milk hypocalcemia
P71.1 Other neonatal hypocalcaemia
ICD-10 online (WHO version 2019)

Hypocalcemia (also hypocalcemia, hypocalcemia, or hypocalcemia ) is abnormally low levels of calcium in the blood. In humans, one speaks of hypocalcemia, when the calcium level in the blood serum of below 2.2 mmol / l (9 mg / dl) or the content of calcium - ion below 1.1 mmol / l (4.5 mg / dl) is located. It causes a disruption of the balance between different electrolytes and can lead to an over-excitability of the nervous system , which manifests itself in cramps in the skeletal muscles . In some cases, one is spasm of smooth muscle triggered. In general, the parathyroid hormone counteracts hypocalcemia in the short term, calcitriol serves to adjust the calcium level to normal values ​​over the long term.

Etiology and pathogenesis

Possible causes of hypocalcemia are:

Symptoms

The main symptom of hypocalcemia is hypocalcemic tetany , a seizure while conscious as a result of hyperreactivity of the muscle spindle , often associated with paresthesia , paws and glottis . Another sign is the Chvostek sign , in which tapping the facial nerve in front of the temporomandibular joint causes the corners of the mouth to twitch. The Trousseau sign can also appear. A few minutes after applying a blood pressure cuff to the arm, paws are inflated using the systolic blood pressure.

The ECG shows a QT prolongation.

Differential diagnosis

A possible differential diagnosis is hyperventilation tetany , in which total calcium is normal, but ionized calcium is reduced as a result of respiratory alkalosis .

therapy

Therapy must turn off the triggering reason. If there is an acute need for treatment, calcium is administered intravenously (about 5–10 mg / kg over several minutes); for long-term treatment, calcium and vitamin D are administered orally.

See also

literature

  • G. Herold and others: Internal medicine. Self-published, Cologne 2005, OCLC 314915893 .
  • Deetjen, Speckmann, Hescheler: Repetitorium Physiologie. 1st edition. Urban & Fischer, 2005, ISBN 3-437-41314-7 .
  • RF Schmidt, F. Lang, G. Thews: Physiology of humans. 29th edition. Springer, Berlin et al. 2005, ISBN 3-540-21882-3 .

Individual evidence

  1. ^ ME Meininger, JS Kendler: Images in clinical medicine. Trousseau's sign . In: The New England Journal of Medicine . tape 343 , no. December 25 , 2000, pp. 1855 , PMID 11117978 .
  2. Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 56.