From the Guidelines
Hypocalcemia is commonly associated with fatigue, emotional irritability, abnormal involuntary movements, seizures, and cardiac arrhythmias, including prolongation of the QT interval, and may predispose to osteopenia/osteoporosis. According to the most recent evidence 1, hypocalcemia can be associated with various symptoms, including neuromuscular irritability, which can manifest as paresthesias, muscle cramps, and tetany. Patients may also exhibit positive Chvostek's sign and Trousseau's sign. Severe hypocalcemia can lead to seizures, laryngospasm, bronchospasm, prolonged QT interval on ECG, and heart failure. Mental status changes, such as confusion, irritability, and depression, may also occur.
Some key findings in hypocalcemia include:
- Fatigue
- Emotional irritability
- Abnormal involuntary movements
- Seizures
- Cardiac arrhythmias, including prolongation of the QT interval
- Osteopenia/osteoporosis
- Neuromuscular irritability, manifested as paresthesias, muscle cramps, and tetany
- Positive Chvostek's sign and Trousseau's sign
It is essential to note that hypocalcemia can be worsened by alcohol or carbonated beverages, such as colas, and that there is an increased risk of hypocalcemia with any biological stress, such as surgery, childbirth, or infection 1. Regular investigations, including measurements of pH-corrected ionized calcium, magnesium, parathyroid hormone, and creatinine concentrations, are recommended. Daily calcium and vitamin D supplementation are also recommended for all adults with 22q11.2DS, and magnesium supplementation is indicated for those with hypomagnesemia 1.
From the FDA Drug Label
The usual adult dosage in hypocalcemic disorders ranges from 200 mg to 1 g (2 -10 mL) at intervals of 1 to 3 days depending on the response of the patient and/or results of serum ionized calcium determinations.
The common findings in hypocalcemia are not directly stated in the provided drug label. The FDA drug label does not answer the question.
From the Research
Common Findings in Hypocalcemia
- Clinical manifestations of hypocalcemia may involve almost any organ and system and may range from asymptomatic to life-threatening conditions 2
- Disorders causing hypocalcemia can be divided into parathyroid hormone (PTH) and non-PTH mediated forms 2
- The most frequent cause of hypocalcemia is postsurgical hypoparathyroidism 2
- Symptoms of hypocalcemia can be resolved or minimized with intravenous calcium infusion in the setting of acute hypocalcemia 2
- Oral calcium and/or vitamin D supplementation is the most frequently used treatment for chronic hypocalcemia 2
Treatment and Management
- Providing the missing hormone with the use of the recombinant human (rh) PTH(1-84) has been recently approved for the treatment of hypoparathyroidism 2
- This new therapy has the advantage of being effective for correcting serum calcium levels and significantly reducing the daily requirements of calcium and active vitamin D supplements 2
- However, due to the high cost, a strict selection of candidates to this therapy is necessary 2
Note on Relevance of Studies
- The study from 1994 3 does not provide relevant information on hypocalcemia, as it focuses on the biogenesis of unconventional integral membrane and secretory proteins.