From the Guidelines
Infections such as sepsis, severe systemic infections, and possibly those associated with 22q11.2 deletion syndrome can cause hypocalcemia, particularly in the context of biological stress 1. When considering the relationship between infections and hypocalcemia, it's crucial to understand that any biological stress, including infection, can predispose individuals to hypocalcemia, especially in those with underlying conditions like 22q11.2 deletion syndrome.
- Key points to consider include:
- The role of biological stress in exacerbating hypocalcemia, as noted in the context of 22q11.2DS 1.
- The importance of monitoring calcium levels, especially during vulnerable times such as severe illness 1.
- The need for targeted treatment, which may include calcium and vitamin D supplementation, under the guidance of a healthcare professional 1. Given the potential for infections to trigger or worsen hypocalcemia, particularly in susceptible populations, it is essential to monitor and manage calcium levels promptly in the context of infection, considering the individual's overall health status and any underlying conditions 1.
From the Research
Types of Infections that can Cause Hypocalcemia
- Sepsis, particularly gram-negative sepsis, can cause hypocalcemia 2
- Bacterial infections, such as those causing osteomyelitis, can also lead to hypocalcemia 3, 4
- Septic shock, often associated with hypoalbuminemia, can alter calcium homeostasis and contribute to hypocalcemia 5
Mechanisms of Hypocalcemia in Infections
- Acquired parathyroid gland insufficiency, renal 1 alpha-hydroxylase insufficiency, vitamin D deficiency, and acquired calcitriol resistance can contribute to hypocalcemia during sepsis 2
- Derangements in calcium homeostasis, sensitive to calcium administration, can occur during sepsis and mediate heightened inflammation and vascular leak 6
Clinical Implications
- Hypocalcemia during sepsis is associated with a high mortality rate and usually occurs in previously normocalcemic patients who acquire a defect in the parathyroid-vitamin D axis 2
- Calcium administration in septic patients may impose harm and is associated with an increased risk of death, renal dysfunction, and reduced ventilator-free days 6