Diagnosis and management of hypocalcaemia

doi:10.1136/bmj.39582.589433.BE

BMJ 2008;336:1298-1302 (7 June), doi:10.1136/bmj.39582.589433.BE

Clinical Review

Diagnosis and management of hypocalcaemia

Mark S Cooper, senior lecturer and consultant endocrinologist, Neil J L Gittoes, senior lecturer and consultant endocrinologist

¹ Division of Medical Sciences, University of Birmingham, Birmingham B15 2TH

Correspondence to: N J L Gittoes, Department of Endocrinology, Queen Elizabeth Hospital, Birmingham B15 2TH n.j.gittoes@bham.ac.uk

The first 150 words of the full text of this article appear below.

Hypocalcaemia is a potentially life threatening biochemicalabnormality that carries risks for serious errors in diagnosisand treatment. Hypocalcaemia presents in primary and secondarycare; it has a prevalence of 18% in all patients in hospitaland 85% in the intensive care unit.¹ ² The most common causeof hypocalcaemia in primary care is vitamin D deficiency, which—dependingon population demographics—may have a prevalence as highas 50%.³ Hypocalcaemia may be an asymptomatic laboratory findingor a life threatening metabolic disturbance. Acute hypocalcaemiacan result in severe symptoms that require rapid admission tohospital and correction. In contrast, when hypocalcaemia developsslowly patients can be surprisingly free of symptoms. This reviewwill help clinicians to optimise the diagnosis and managementof patients with hypocalcaemia. Because hypocalcaemia oftenpresents as an emergency and symptoms are rapidly reversed bygiving calcium, the evidence base for managing acute hypocalcaemiais mostly based on experience . . . [Full text of this article]

Sources and selection criteria

Who gets hypocalcaemia and why?

Hypocalcaemia with low vitamin D concentrations
Hypocalcaemia with reduced parathyroid hormone function

How does hypocalcaemia present in clinical practice?

What is clinically relevant hypocalcaemia?

Summary points

Which tests help make the diagnosis and define the cause of hypocalcaemia?

Additional educational resources

How is hypocalcaemia treated?

Acutely presenting hypocalcaemia
Unanswered questions
Persistent hypocalcaemia

Conclusion

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