The following drugs, medications, substances or toxins are some of the possible
causes of Hypocalcemia as a symptom.
This list is incomplete and various other drugs or substances
may cause your symptoms.
Always advise your doctor of any medications or treatments you are using,
including prescription, over-the-counter, supplements, herbal or alternative treatments.
As with all medical conditions,
there may be many causal factors.
Further relevant information on causes of Hypocalcemia may be found in:
Hypoalbuminemia commonly results in a
“pseudohypocalcemia”
–Results in decreased total serum Ca2+
but normal free, ionized (active) Ca2+
–Does not result in sequelae of hypocalcemia
- Hypoparathyroidism
–Often occurs after thyroidectomy or parathyoidectomy
–Infiltrative diseases of the parathyroid gland (e.g., hemochromatosis, Wilson's disease, sarcoidosis, tuberculosis)
–Pseudohypoparathyroidism (parathyroid hormone resistance)
–Idiopathic (autoimmune)
-
Medications (e.g., diuretics, heparin, foscarnet, cimetidine, glucagon, phosphates, aminoglycosides, theophylline, cisplatin)
-
Vitamin D deficiency
–Poor oral intake and/or absent sun exposure
–Malabsorption
–Hepatic and/or renal failure
–Anticonvulsant use
-
Pancreatitis
-
Alkalosis (especially respiratory alkalosis)
-
Sepsis
-
Shock
-
Burns
-
Magnesium deficiency (often seen in alcoholism)
-
Hyperphosphatemia
-
Alcoholism (may directly suppress PTH and/or deplete magnesium)
-
Postoperative (usually transient)
-
Post-blood transfusion
-
Malignancy
–Medullary carcinoma of the thyroid
–Osteoblastic metastases
-
Familial hypocalcemia
-
DiGeorge's syndrome (congenital absence of the parathyroid glands)
-
Polyglandular autoimmune syndrome, type I (hypoparathyroidism, adrenal insufficiency, and mucocutaneous candidiasis)
-
Rickets
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hypocalcemia:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
- Hypoparathyroidism
–Congenital: Transient neonatal vs heritable forms
–Acquired: Autoimmune, postsurgical,
radioablation, infiltrative
–DiGeorge Syndrome
–Polyglandular autoimmune disease type 1
(Blizzard syndrome)
–Pseudohypoparathyroidism (PHP) or PTH resistance
–PHP type IA (Albright dereditary osteodystrophy)
–PHP type IB, type II
- Vitamin D deficiency
–Nutritional deprivation
–Most common cause of rickets
–Seen in breast-fed and black children
–Malabsorption/steatorrhea/liver disease
–1-αhydroxylase deficiency
–Chronic renal disease
-
Calcium deficiency
–Nutritional deprivation
–Malabsorption
–Hypercalciuria
-
Hypomagnesemia
–Impairs secretion of, and end-organ
responsiveness to, PTH
–Inherited forms
–Intestinal losses
–Renal wasting: RTA, drugs
-
Hyperphosphatemia
-
Hypoproteinemia
–Total calcium is a measure of calcium bound to albumin
-
Drugs
–Loop diuretics (furosemide) promote renal calcium excretion
–Anticonvulsants interfere with GI vitamin D
absorption
–Antacids impair GI calcium absorption
–Antineoplastic agents
–Citrated blood products
-
Critical illness
–Rhabdomyolysis
–Toxic shock syndrome
–Pancreatitis
-
Organic acidemia
-
Infant of a diabetic mother
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Chvostek's sign:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Hypocalcemia.
The degree of muscle spasm elicited reflects the patient's serum calcium level. Initially, hypocalcemia produces paresthesia in the fingers, toes, and circumoral area that progresses to muscle tension and carpopedal spasms. The patient may also complain of muscle weakness, fatigue, and palpitations. Muscle twitching, hyperactive deep tendon reflexes, choreiform movements, and muscle cramps may also occur. The patient with chronic hypocalcemia may have mental status changes; diplopia; difficulty swallowing; abdominal cramps; dry, scaly skin; brittle nails; and thin, patchy scalp and eyebrow hair.
Other causes
Blood transfusion.
A massive transfusion can lower serum calcium levels and allow Chvostek's sign to be elicited.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Carpopedal spasm:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Hypocalcemia.
Carpopedal spasm is an early sign of hypocalcemia. It's usually accompanied by paresthesia of the fingers, toes, and perioral area; muscle weakness, twitching, and cramping; hyperreflexia; chorea; fatigue; and palpitations. Positive Chvostek's and Trousseau's signs can be elicited. Laryngospasm, stridor, and seizures may appear in severe hypocalcemia.
Chronic hypocalcemia may be accompanied by mental status changes; cramps; dry, scaly skin; brittle nails; and thin, patchy hair and eyebrows.
Tetanus.
Tetanus develops when Clostridium tetani enters a wound in a nonimmunized individual. The patient develops muscle spasms and painful seizures. Difficulty swallowing and a low-grade fever are also present. If the patient isn't treated or treatment is delayed, the mortality rate is very high.
Other causes
Treatments.
Multiple blood transfusions and parathyroidectomy may cause hypocalcemia, resulting in carpopedal spasm. Surgical procedures that impair calcium absorption, such as ileostomy formation and gastric resection with gastrojejunostomy, may also cause hypocalcemia.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Calcium imbalance:
Causes
(Professional Guide to Diseases (Eighth Edition))
Common causes of hypocalcemia include:
❑ inadequate intake of calcium and vitamin D, in which inadequate levels of vitamin D inhibit intestinal absorption of calcium
❑ hypoparathyroidism as a result of injury, disease, or surgery that decreases or eliminates secretion of parathyroid hormone (PTH), which is necessary for calcium absorption and normal serum calcium levels
❑ malabsorption or loss of calcium from the GI tract, caused by increased intestinal motility from severe diarrhea or laxative abuse; can also result from inadequate levels of vitamin D or PTH, or a reduction in gastric acidity, decreasing the solubility of calcium salts
❑ severe infections or burns, in which diseased and burned tissue traps calcium from the extracellular fluid
❑ overcorrection of acidosis, resulting in alkalosis, which causes decreased ionized calcium and induces symptoms of hypocalcemia
❑ pancreatic insufficiency, which may cause malabsorption of calcium and subsequent calcium loss in feces. In pancreatitis, participation of calcium ions in saponification contributes to calcium loss
❑ renal failure, resulting in excessive excretion of calcium secondary to increased retention of phosphate
❑ hypomagnesemia, which causes decreased PTH secretion and blocks the peripheral action of that hormone.
Causes of hypercalcemia include the following:
❑ hyperparathyroidism, which increases serum calcium levels by promoting calcium absorption from the intestine, resorption from bone, and reabsorption from the kidneys
❑ hypervitaminosis D, which can promote increased absorption of calcium from the intestine
❑ tumors, which raise serum calcium levels by destroying bone or by releasing PTH or a PTH-like substance, osteoclast-activating factor, prostaglandins and, perhaps, a vitamin D-like sterol
❑ multiple fractures and prolonged immobilization, which release bone calcium and raise the serum calcium level
❑ multiple myeloma, which promotes loss of calcium from bone.
Other causes include milk-alkali syndrome, sarcoidosis, hyperthyroidism, adrenal insufficiency, thiazide diuretics, and loss of serum albumin secondary to renal disease.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Chvostek's sign:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Hypocalcemia
The degree of muscle spasm elicited reflects the patient’s serum calcium level. Initially, hypocalcemia produces paresthesia in the fingers, toes, and circumoral area that progresses to muscle tension and carpopedal spasms. The patient may also complain of muscle weakness, fatigue, and palpitations. Muscle twitching, hyperactive deep tendon reflexes, choreiform movements, and muscle cramps may also occur. The patient with chronic hypocalcemia may have mental status changes; diplopia; difficulty swallowing; abdominal cramps; dry, scaly skin; brittle nails; and thin, patchy scalp and eyebrow hair.
Other causes
Blood transfusion
A massive transfusion can lower serum calcium levels and allow Chvostek’s sign to be elicited.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Carpopedal spasm:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Hypocalcemia
Carpopedal spasm is an early sign of hypocalcemia. It’s usually accompanied by paresthesia of the fingers, toes, and perioral area; muscle weakness, twitching, and cramping; hyperreflexia; chorea; fatigue; and palpitations. Positive Chvostek’s and Trousseau’s signs can be elicited. Laryngospasm, stridor, and seizures may appear in severe hypocalcemia.
Chronic hypocalcemia may be accompanied by mental status changes; cramps; dry, scaly skin; brittle nails; and thin, patchy hair and eyebrows.
Tetanus
Tetanus is an infectious disease that develops when Clostridium tetani enters a wound in a nonimmunized individual. The patient develops muscle spasms, painful seizures, difficulty swallowing, and a low-grade fever. Without prompt treatment, mortality is very high.
Other causes
Treatments
Multiple blood transfusions and parathyroidectomy may cause hypocalcemia, resulting in carpopedal spasm. Surgical procedures that impair calcium absorption, such as ileostomy formation and gastric resection with gastrojejunostomy, may also cause hypocalcemia.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Calcium imbalance:
Causes
(Handbook of Diseases)
Several factors can cause calcium imbalance.
Hypocalcemia
❑ Inadequate intake of calcium and vitamin D results in inhibited intestinal absorption of calcium.
❑ Hypoparathyroidism as a result of injury, disease, or surgery decreases or eliminates secretion of parathyroid hormone (PTH), which is necessary for calcium absorption and normal serum calcium levels.
❑ Malabsorption or loss of calcium from the GI tract can result from increased intestinal motility from severe diarrhea or laxative abuse. Malabsorption of calcium from the GI tract can also result from inadequate levels of vitamin D or PTH or a reduction in gastric acidity, which decreases the solubility of calcium salts.
❑ Severe infections or burns can lead to diseased and burned tissue trapping calcium from the extracellular fluid.
❑ Overcorrection of acidosis can lead to alkalosis, which causes decreased ionized calcium and induces symptoms of hypocalcemia.
❑ Pancreatic insufficiency may cause malabsorption of calcium and subsequent calcium loss in stool. In pancreatitis, participation of calcium ions in saponification contributes to calcium loss.
❑ Renal failure results in excessive excretion of calcium secondary to increased phosphate retention. Renal failure also results in loss of the active metabolite of vitamin D, which impairs calcium absorption.
❑ Hypomagnesemia causes decreased PTH secretion and blocks the peripheral action of that hormone.
Hypercalcemia
❑ Hyperparathyroidism increases serum calcium levels by promoting calcium absorption from the intestine, resorption from bone, and reabsorption from the kidneys.
❑ Hypervitaminosis D can promote increased absorption of calcium from the intestine.
❑ Tumors raise serum calcium levels by destroying bone or by releasing PTH or a PTH-like substance, osteoclast-activating factor, prostaglandins and, perhaps, a vitamin D–like sterol.
❑ Multiple fractures and prolonged immobilization release bone calcium and raise the serum calcium level.
❑ Multiple myeloma promotes loss of calcium from bone.
Other causes include milk-alkali syndrome, sarcoidosis, hyperthyroidism, adrenal insufficiency, and thiazide diuretics.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Carpopedal spasm:
Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Hypocalcemia.
Carpopedal spasm is an early sign of hypocalcemia. It’s usually accompanied by paresthesia of the fingers, toes, and perioral area; muscle weakness, twitching, and cramping; hyperreflexia; chorea; fatigue; and palpitations. Positive Chvostek’s and Trousseau’s signs can be elicited. Laryngospasm, stridor, and seizures may appear in severe hypocalcemia.
Chronic hypocalcemia may be accompanied by mental status changes; cramps; dry, scaly skin; brittle nails; and thin, patchy hair and eyebrows.
Tetanus is an infectious disease that develops when Clostridium tetani enters a wound in a nonimmunized individual. The patient develops muscle spasms and painful seizures. Difficulty swallowing and low-grade fever are also present. If the patient isn’t treated or treatment is delayed, the mortality rate is very high.
Other causes
Multiple blood transfusions and parathyroidectomy may cause hypocalcemia, resulting in carpopedal spasm. Surgical procedures that impair calcium absorption, such as ileostomy formation and gastric resection with gastrojejunostomy, may also cause hypocalcemia.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Chvostek's sign:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Hypocalcemia
Chvostek’s sign may indicate hypocalcemia. The degree of muscle spasm elicited reflects the patient’s serum calcium level. Initially, hypocalcemia produces paresthesia in the fingers, toes, and circumoral area that progresses to muscle tension and carpopedal spasms. The patient may also complain of muscle weakness, fatigue, and palpitations. Muscle twitching, hyperactive deep tendon reflexes, choreiform movements, and muscle cramps may also occur. The patient with chronic hypocalcemia may have mental status changes; diplopia; difficulty swallowing; abdominal cramps; dry, scaly skin; brittle nails; and thin, patchy scalp and eyebrow hair.
Other causes
Treatments
A massive blood transfusion can lower serum calcium levels and allow Chvostek’s sign to be elicited.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Carpopedal spasm:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Hypocalcemia
Carpopedal spasm is an early sign of hypocalcemia. It’s usually accompanied by paresthesia of the fingers, toes, and perioral area; muscle weakness, twitching, and cramping; hyperreflexia; chorea; fatigue; and palpitations. Positive Chvostek’s and Trousseau’s signs can be elicited. Laryngospasm, stridor, and seizures may appear in severe hypocalcemia.
Chronic hypocalcemia may be accompanied by mental status changes; cramps; dry, scaly skin; brittle nails; and thin, patchy hair and eyebrows.
Tetanus
With tetanus, an infectious disease caused by Clostridium tetani, the patient develops muscle spasms and painful seizures. Difficulty swallowing and a low-grade fever are also present. If the patient isn’t treated or treatment is delayed, the mortality rate is very high.
Other causes
Treatments
Multiple blood transfusions and parathyroidectomy may cause hypocalcemia, resulting in carpopedal spasm.
Surgical procedures
Surgical procedures that impair calcium absorption, such as ileostomy formation and gastric resection with gastrojejunostomy, may also cause hypocalcemia.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Chvostek's sign:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Hypocalcemia.The degree of muscle spasm elicited reflects the patient's serum calcium level. Initially, hypocalcemia produces paresthesia in the fingers, toes, and circumoral area that progresses to muscle tension and carpopedal spasms. The patient may also complain of muscle weakness, fatigue, and palpitations. Muscle twitching, hyperactive deep tendon reflexes, choreiform movements, and muscle cramps may also occur. The patient with chronic hypocalcemia may have mental status changes; diplopia; difficulty swallowing; abdominal cramps; dry, scaly skin; brittle nails; and thin, patchy scalp and eyebrow hair.
Other causes
Blood transfusion.A massive blood transfusion can lower serum calciumlevels and allow Chvostek's sign to be elicited.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Carpopedal spasm:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Hypocalcemia.Carpopedal spasm is an early sign of hypocalcemia. It's usually accompanied by paresthesia of the fingers, toes, and perioral area; muscle weakness, twitching, and cramping; hyperreflexia; chorea; fatigue; and palpitations. Positive Chvostek's and Trousseau's signs can be elicited. Laryngospasm, stridor, and seizures may appear in severe hypocalcemia.
Chronic hypocalcemia may be accompanied by mental status changes; cramps; dry, scaly skin; brittle nails; and thin, patchy hair and eyebrows.
Tetanus.With tetanus, the patient develops muscle spasms and painful seizures. Difficulty swallowing and a low-grade fever are also present. If the patient isn't treated or treatment is delayed, the mortality rate is very high.
Other causes
Treatments.Multiple blood transfusions and parathyroidectomy may cause hypocalcemia, resulting in carpopedal spasm. Surgical procedures that impair calcium absorption, such as ileostomy formation and gastric resection with gastrojejunostomy, may also cause hypocalcemia.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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