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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.
Post-surgical hypoparathyroidism is the most common form, and can be temporary (due to suppression of tissue after removal of a malfunctioning gland) or permanent, if all parathyroid tissue has been removed. [1] Inherited hypoparathyroidism is rare and is due to a mutation in the calcium sensing receptor.
The Chvostek sign (/ ˈ k v ɒ s t ɪ k /) is a clinical sign that someone may have a low blood calcium level (a decreased serum calcium, called hypocalcemia).The Chvostek sign is the abnormal twitching of muscles that are activated (innervated) by the facial nerve (also known as Cranial Nerve Seven, or CNVII). [1]
From 1 to 4 percent of normal patients will test positive for Trousseau's sign of latent tetany. [2] This sign may be positive before other manifestations of hypocalcemia such as hyperreflexia and tetany, as such it is generally believed to be more sensitive (94%) than the Chvostek sign (29%) for hypocalcemia.
Though calcium is the most plentiful electrolyte in the body, a large percentage of it is used to form the bones. [14] It is mainly absorbed and excreted through the GI system. [ 14 ] The majority of calcium resides extracellularly, and it is crucial for the function of neurons , muscle cells , function of enzymes , and coagulation . [ 14 ]
Calcium is the most abundant mineral in the human body. [3] The average adult body contains in total approximately 1 kg, 99% in the skeleton in the form of calcium phosphate salts. [3] The extracellular fluid (ECF) contains approximately 22 mmol, of which about 9 mmol is in the plasma. [4]
If the underlying cause of the hypocalcemia can be addressed, the hyperparathyroidism will resolve. In people with chronic kidney failure, treatment consists of dietary restriction of phosphorus; supplements containing an active form of vitamin D, such as calcitriol, doxercalciferol, paricalcitol; and phosphate binders, which are either calcium-based and non-calcium based.
[citation needed] Low activated vitamin D 3 levels are a result of the damaged kidneys' inability to convert vitamin D 3 into its active form, calcitriol, and result in further hypocalcemia. High levels of fibroblast growth factor 23 seem to be the most important cause of decreased calcitriol levels in CKD patients. [citation needed]