Utente:Esmeralda Scarati/Sandbox
Template:For Template:Infobox medical condition (new) Hypocalcemia is low calcium levels in the blood serum.[1] 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 hypocalcemia.[2][3][4] Mildly low levels that develop slowly often have no symptoms.[5][6] Otherwise symptoms may include numbness, muscle spasms, seizures, confusion, or cardiac arrest.[2][5]
Common causes include hypoparathyroidism and vitamin D deficiency.[5] Others causes include kidney failure, pancreatitis, calcium channel blocker overdose, rhabdomyolysis, tumor lysis syndrome, and medications such as bisphosphonates.[2] Diagnosis should generally be confirmed with a corrected calcium or ionized calcium level.[5] Specific changes may be seen on an electrocardiogram (ECG).[2]
Initial treatment for severe disease is with intravenous calcium chloride and possibly magnesium sulfate.[2] Other treatments may include vitamin D, magnesium, and calcium supplements.[5] If due to hypoparathyroidism, hydrochlorothiazide, phosphate binders, and a low salt diet may also be recommended.[5] About 18% of people who are being treated in hospital have hypocalcemia.[6]
Signs and symptoms[modifica | modifica wikitesto]
The neuromuscular symptoms of hypocalcemia are caused by a positive bathmotropic effect (i.e. increased responsiveness) due to the decreased interaction of calcium with sodium channels. Since calcium blocks sodium channels and inhibits depolarization of nerve and muscle fibers, reduced calcium lowers the threshold for depolarization.[7] The symptoms can be recalled by the mnemonic "CATs go numb" - convulsions, arrhythmias, tetany, and numbness in the hands and feet and around the mouth.[senza fonte] Template:Columns-list
- ^ (EN) Medical-Surgical Nursing, Pearson Higher Education AU, 2015, p. 237, ISBN 9781486014408.
- ^ a b c d e European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution., in Resuscitation, vol. 81, n. 10, October 2010, pp. 1400–33, DOI:10.1016/j.resuscitation.2010.08.015.
- ^ Appendix 1: Conversion of SI Units to Standard Units, in Principles and practice of geriatric medicine, 4.ª ed., Chichester [u.a.], Wiley, 2006, Appendix, DOI:10.1002/047009057X.app01, ISBN 9780470090558.
- ^ The diagnosis and management of hypercalcaemia, in BMJ (Clinical Research Ed.), vol. 350, 2 June 2015, pp. h2723, DOI:10.1136/bmj.h2723.
- ^ a b c d e f Hypocalcemia: updates in diagnosis and management for primary care, in Canadian Family Physician, vol. 58, n. 2, February 2012, pp. 158–62.
- ^ a b Diagnosis and management of hypocalcaemia, in BMJ (Clinical Research Ed.), vol. 336, n. 7656, 7 June 2008, pp. 1298–302, DOI:10.1136/bmj.39582.589433.be.
- ^ Calcium block of Na+ channels and its effect on closing rate, in Proceedings of the National Academy of Sciences of the United States of America, vol. 96, n. 7, 1999, pp. 4154–4157, DOI:10.1073/pnas.96.7.4154.