Diagnosis and management of hypocalcemia

Pepe, Jessica; Colangelo, Luciano; Biamonte, Federica; Sonato, Chiara; Danese, Vittoria Carmela; Cecchetti, Veronica; Occhiuto, Marco; Piazzolla, Valentina; Martino, Viviana De; Ferrone, Federica; Minisola, Salvatore; Cipriani, Cristiana

doi:10.1007/s12020-020-02324-2

Cited by 93 publications

(77 citation statements)

References 67 publications

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“…Severe COVID-19 was defined as intensive care unit (ICU) admission or all-cause mortality within 28 d after hospital admission. Hypocalcaemia was defined as plasma calcium <2.12 mmol/L or ionized plasma calcium <1.17 mmol/L regardless of correction for albumin and pH, respectively [19].…”

Section: Study Design and Settingmentioning

confidence: 99%

Lower plasma calcium associated with COVID-19, but not with disease severity: a two-centre retrospective cohort study

Deodatus

Kooistra

Kurstjens

et al. 2021

Infectious Diseases

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Background: Previous studies indicate hypocalcaemia as a potential diagnostic and prognostic marker of corona-virus disease 2019 (COVID-19). Our aim was to investigate these relations in more detail in a large test cohort and an independent validation cohort. Methods: We retrospectively included 2792 COVID-19 suspected patients that presented to the emergency department (ED) of two hospitals. Plasma calcium and ionized plasma calcium levels were compared between COVID-19 positive and negative patients, and between severe and non-severe COVID-19 patients using univariate and multivariate analyses in the first hospital (N ¼ 1363). Severe COVID-19 was defined as intensive care unit (ICU) admission or death within 28 d after admission. The results were validated by repeating the same analyses in the second hospital (N ¼ 1429). Results: A total of 693 (24.8%) of the enrolled patients were COVID-19 positive, of whom 238 (34.3%) had severe COVID-19. In both hospitals, COVID-19 positive patients had lower plasma calcium levels than COVID-19 negative patients, regardless of correction for albumin, in univariate and multivariate analysis (D0.06-0.13 mmol/L, p < .001). Ionized plasma calcium concentrations, with and without correction for pH, were also lower in COVID-19 positive patients in multivariate analyses (D0.02-0.05 mmol/L, N ¼ 567, p < .001). However, we did not find a significant association between COVID-19 disease severity and plasma calcium in multivariate analyses. Conclusions: Plasma calcium concentrations were lower in COVID-19 positive than COVID-19 negative patients but we found no association with disease severity in multivariate analyses. Further understanding of plasma calcium perturbation may facilitate the development of new preventive and therapeutic modalities for the current pandemic.

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Section: Study Design and Settingmentioning

confidence: 99%

Lower plasma calcium associated with COVID-19, but not with disease severity: a two-centre retrospective cohort study

Deodatus

Kooistra

Kurstjens

et al. 2021

Infectious Diseases

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“…However, most of these cases of hypocalcemia will be asymptomatic and clinically irrelevant. Interventions must be considered only when hypocalcemia is coupled with symptoms, or ionic calcium less than 0.9 mmol/L ( 48 ).…”

Section: Frequent Mistakes In the Evaluation Of Miscellaneous Endocrine Testsmentioning

confidence: 99%

Common Pitfalls in the Interpretation of Endocrine Tests

et al. 2021

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Endocrine tests are the cornerstone of diagnosing multiple diseases that primary care physicians are frequently faced with. Some of these tests can be affected by situations that affect the proper interpretation, leading to incorrect diagnoses and unnecessary treatment, such as the interference of biotin with thyroid function test, falsely elevated prolactin values in presence of macroprolactinemia or falsely normal due to the “hook effect” in macroprolactinomas. Recognizing these situations is essential for the clinician to make an adequate interpretation of these tests as well as an accurate diagnosis that guarantees the best outcomes for the patient.

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“…Apesar da hipocalcemia ocasionada por doença renal crônica raramente apresentar sinais clínicos, é preciso se atentar a ocorrência de tremores, fasciculações musculares, câimbras, inquietação, irritabilidade, respiração ofegante, letargia e até mesmo a paradas respiratórias (de Brito Galvão et al, 2017). Esses sintomas podem aparecer pois o cálcio tem um importante papel na função neuromuscular, com influência direta na força, equilíbrio e velocidade de contração muscular (Shrimanker & Bhattarai, 2020), por meio da regulação do transporte de cálcio, síntese proteica e cinética da contração (Pepe et al, 2020).…”

Section: Discussionunclassified

El dolor orofacial y su relación con la hipocalcemia asociada a la enfermedad renal crónica: un diagnóstico diferencial pasado por alto

Santos

Barbosa²,

Palin

et al. 2021

RSD

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Aunque el dolor orofacial es una condición de etiopatogenia multifactorial y en ocasiones es difícil de diagnosticar, una posible causa de esta condición son los cambios musculares, que a su vez pueden originarse en condiciones sistémicas, como la hipocalcemia. El presente artículo tiene como objetivo presentar una situación clínica de dolor orofacial por hipocalcemia en una paciente joven con enfermedad renal crónica. El paciente acudió a atención hospitalaria con fuertes quejas de dolor en el rostro, siendo evaluado por el equipo de Cirugía Maxilofacial y el equipo médico de Neurología, sin la determinación precisa de una etiología. A pesar de que se le prescribió medicación oral, el paciente regresó con la queja de dolor y con un nuevo síntoma de calambres en el rostro, ante lo cual se solicitó pruebas hematológicas donde se encontró una condición de hipocalcemia. El enfoque terapéutico consistió en suplementos de calcio por vía oral, que fue suficiente para suprimir las molestias faciales. Se concluye que existe una correlación entre la concentración de calcio en sangre y los cambios musculares en el rostro, requiriendo estudios clínicos para explicar mejor esta relación.

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Diagnosis and management of hypocalcemia

Cited by 93 publications

References 67 publications

Lower plasma calcium associated with COVID-19, but not with disease severity: a two-centre retrospective cohort study

Lower plasma calcium associated with COVID-19, but not with disease severity: a two-centre retrospective cohort study

Common Pitfalls in the Interpretation of Endocrine Tests

El dolor orofacial y su relación con la hipocalcemia asociada a la enfermedad renal crónica: un diagnóstico diferencial pasado por alto

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