Blood Calcium Deficiency

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Blood calcium deficiency

 

The word hypochalemia comes from the term hypokalemia in English, which is documented in medical literature between 1945 and 1950, and means an abnormally low potassium concentration in the blood of, when the value is less than 3.5 mEq / L., In the case of the human being.

The term is formed by the following elements: the Greek prefix ὑπό- Hypó-, which originally means ‘under’, but in scientific terminology it is translated as ‘low values ​​of’ or ‘low level of’; Kalium (in modern Latin), from Kali, ‘potassium’, derived from the Arab term ‘alkali’; and αιμία = haimíā, haimo, haim, de haima, ‘blood’. Literally then, and analyzing each component, hypocalemia is: ‘Postassium level (Kalium) low (Hypó) in the blood (Haima)’. While in English the word retained the letter ‘K’, by the chemical symbol (k) of the potassium, in Spanish it was adopted hypocalemia, but this word has nothing to do with Calx, Calcis, which in Latin is ‘the lime’, because for cases that refer to calcium levels, hypocalcemia (low level) and hypercalcemia are used (high level).

It is defined as the concentration of total serum calcium less 8.5 mg/dl (4.5 mEq/l, 2.10 mmol/l), but the clinical hypocalcemia can be presented with normal total calcium values ​​when the serum calcium concentration ionic is less than 4.5 mg/dl. In surgery, the most common cause of hypocalcemiah hyperventilation and infusion of citrated blood Mayora 1.5 ml/kg/min.

Hypocalcemia can be asymptomatic, or more frequently, it can occur clinically with perioral or peripheral parstesties, muscle cramps, carpal or pedio spasm, even tetania and acute confusional states. Symptomatic patients usually require prolonged hospitalization after thyroid surgery, which causes increased health care costs. According to the extension of the lesion to the parathyroid glands, hypocalcemia can be transient (also called transitory hypoparathyroidism) or permanent, in which case it requires supplementation with calcium and active vitamin D, for the rest of life.

Causes

The main causes of hypocalcemia in adults can be grouped, according to the pathophysiological mechanism that produces them, in hypoalbuminemia, loss of calcium of circulation and poor contribution from the intestine or bone.

Hypocalcemia is the result of both the increase in the loss of ionized calcium of the circulatory torrent due to tissues, renal elimination or increased union to circulating proteins, as well as the decrease in calcium contribution to circulation due to bad intestinal absorption or Bone resorption decrease. It is defined as the decrease in total calcium concentration below its reference figure, which is usually 8.5 mg/dl.

Symptoms

Hypocalcemia is clinically manifested by marked and progressive neuromuscular irritability that begins with cramps (when they are facials it is called uffenheimer. Broncoospasm, anxiety of conression-cognitive disorders, papillary edema, respiratory arrest and at the electrocardiographic level Prolongation of the QT interval and ventricular arrhythmias.

Ectodermal alterations (dermatitis, eczema, psoriasis, alopecia, transverse nail furrows), candidiasis in hypoparathyroidism and cataracts in chronic hypocalcemia in chronic hypocalcemia have been reported.

Risk factor’s

The mechanisms responsible for myocardiopathy include hypocalcemia and hypomagnesemia, low circulating values ​​of PTH, other metabolic alterations added secondary to hypoparathyroidism and the presence of underlying myocardiopathy. Hypocalcemia exerts a negative inotropic effect on the phases of contraction-excitation and cardiac conduction, with a characteristic prolongation of the QT interval of the ECG4-6. However, the correction of serum calcium and magnesium values ​​leads to the normalization of cardiac function, constituting an example of reversible myocardiopathy of metabolic origin.

Among the factors that increase the risk of developing severe hypocalcemia, in addition to the previous existence of hypocalcemia, several disorders that tend to prevent this compensating response, such as renal failure, hypomagnesemia, vitamin D deficiency, hypoparathyroidism and ASA diuretics treatment, which increase calciuria.

Conclusions

Hypocalcemia is a relatively frequent finding in medical practice, and its clinical presentation is variable. On many occasions it is a casual finding in an analysis carried out for another reason; other times it can represent a situation of gravity that requires urgent therapeutic measures. Sometimes its cause is evident; Other times your identification requires an exhaustive study.

The problem of hypocalcemia is precisely due to the blood calcium deficiency due to the ideal consumption of vitamin and calcium generators, remember that our human body needs for each part of the body a percentage of calcium and vitamins, this problem affects not only to the general population, but also this disease can be present in the animal species. For this reason, and according to the specialty, our analysis is based exclusively on the affectation to the human species, so that we have considered knowing in all its areas the issue to be developed through web pages consultations, that is, in scientific articles that grant true information, to finally obtain this knowledge that will be applied in professional life.

Bibliography

  1. Hermann Barquero, Melchor; María José Delgado, Rodríguez & Josías Juantá, Castro. Hypocalcemia and post-pyroidectomy hypoparathyroidism. Méd Costarric Vol 57 (4), October 2015; Cited January 2020 18. 
  2. Jose M. Domínguez de Rozas, Damiá Obrador Mayol & Lluis Tomás Abadal. The new definition of myocardial infarction. Rev Esp cardiol vol. 54, no. 11, November 2001; 1345-1348; Cited January 2020 18. 
  3. María Dolores Casas, Francisco Javier López, Longo; Marta García, Castro; Irene Díez, María Carpena & Luis Carreño. Differential diagnosis of hypocalcemic syndromes. Semin Fund Reumatol. 2007; 8: 205-12; Cited January 2020 18.
  4. Díez Herrán, N; Rodríguez, MV; Riancho, JA; González-Torre, AI. Symptomatic hypocalcemia after the administration of bisphosphonates. Magazine of Osteoporosis and Mineral Metabolism, Vol. 4, no. April 2-June, 2012, pp. 89-94; Cited January 2020 18. 
  5. Pacheco, Julio; Guerrero, Yorly; Pedrique, Genoveva; Pérez, Judith; Zerpa, Yajaira; Mérida Endocrinology Group (ENDO-MER) Management of patients with hypoparathyroidism. Venezuelan Magazine of Endocrinology and Metabolism, Vol. 12, no. 3, October, 2014, pp. 204-213; Cited January 2020 17. 
  6. Hung Huang, Sailee; Briceño, Yajaira; Barrios, Mary Carmen; Silvestre, Rebeca; Paoli, Mariela resistance to parathormone as an uncommon cause of late start hypocalcemia in pediatric patients. Case report. Venezuelan Magazine of Endocrinology and Metabolism, Vol. 13, no. September 3, 2015, pp. 175-179; Cited January 2020 16.
  7.  Pablo Young, Marcelo A. Bravo, María G. González, Barbara C. Finn, Mariano A. Quezel, Julio E. Bruetman. Armand Tousseau (1801-1867), his history and the signs of hypocalcemia. Rev Med Chile 2014; 142: 1341-1347; Cited January 2020 18.

 

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