Hypocalcaemia: causes and management
The clinical history combined with parathyroid hormone levels will reveal the cause of hypocalcaemia in the majority of cases
Causes
Acute pancreatitis may also cause hypocalcaemia. Contamination of blood samples with EDTA may also give falsely low calcium levels
Management
Causes
- vitamin D deficiency (osteomalacia)
- chronic renal failure
- hypoparathyroidism (e.g. post thyroid/parathyroid surgery)
- pseudohypoparathyroidism (target cells insensitive to PTH)
- rhabdomyolysis (initial stages)
- magnesium deficiency (due to end organ PTH resistance)
- massive blood transfusion
Acute pancreatitis may also cause hypocalcaemia. Contamination of blood samples with EDTA may also give falsely low calcium levels
Management
- acute management of severe hypocalcaemia is with intravenous replacement. The preferred method is with intravenous calcium gluconate, 10ml of 10% solution over 10 minutes
- intravenous calcium chloride is more likely to cause local irritation
- ECG monitoring is recommended
- further management depends on the underlying cause