Calcium Imbalances: Causes and Manifestations

Calcium Imbalances: Causes and Manifestations

Hypercalcemia (Ca²⁺ >10.2 mg/dL [2.55 mmol/L])

Hypocalcemia (Ca²⁺ <8.6 mg/dL [2.15 mmol/L])

Cause

• Increased Total Calcium

• Decreased Total Calcium

• Hyperparathyroidism

• Primary hypoparathyroidism

• Hematologic malignancy

• Renal insufficiency

• Malignancies with bone metastasis

• Acute pancreatitis

• Prolonged immobilization

• Elevated phosphorus

• Vitamin A or D overdose

• Vitamin D deficiency, malnutrition

• Paget’s disease

• Magnesium deficiency

• Adrenal insufficiency

• Bisphosphonates

• Thyrotoxicosis

• Tumor lysis syndrome

• Thiazide diuretics

• Loop diuretics

• Milk-alkali syndrome

• Chronic alcoholism

• Calcium-containing antacids

• Diarrhea

• Mycobacterium infection

• Decreased Serum albumin

Increased Ionized Calcium

Decreased Ionized Calcium

• Acidosis

• Alkalosis

• Excess administration of citrated blood

ECG changes

• Shortened ST segment

• Elongation of ST segment

• Shortened QT interval

• Prolonged QT interval

• Ventricular dysrhythmias

• Ventricular tachycardia

• Increased digitalis effect