Diagnostic Tests for Hypocalcemia

Diagnostic Test list for Hypocalcemia:

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Hypocalcemia includes:

• Physical examination
  • Examine for physical signs of low calcium including Chvostek's sign (gentle tapping over the facial nerve causes twitching of the facial muscles) and Trousseau's sign (inflation of the blood pressure cuff above diastolic blood pressure for 3 minutes causes muscular contraction of the fingers and wrist)
• Blood tests
  • Full blood count
  • Electrolytes, including calcium and phosphate levels
  • Renal function tests (renal failure is the most common cause of low calcium)
  • PTH level - If PTH level is low must consider hypoparathyroidism (low parathyroid gland function).
  • Phosphorus level - A decreased phosphorus level may suggest malabsorption syndrome, rickets, osteomalacia, renal tubular acidosis, cirrhosis and nephrotic syndrome. An elevated phosphorus level may suggest renal disease or pseudohypoparathryoidism.
  • Alkaline phosphatase level - Elevated in hypocalcemia due to malabsorption syndrome, rickets, osteomalacia, renal tubular acidosis and other chronic renal disease. Normal Alkaline phosphatase level in cirrhosis, nephrosis, alkalosis and pseudohypoparathyroidism.
  • Serum protein electrophoresis
  • Vitamin D level
  • Magnesium level (low magnesium levels due to loss from the gastrointestinal tract or kidneys may cause low calcium levels)
• Urine tests
  • Urinalysis
  • 24 hour urinary calcium
• Radiological investigations
  • Skeletal survey
  • Bone scan
  • X-Ray of hand bones showing short 4th metacarpals, which occur in pseudohypoparathyroidism
• Blood phosphate level
• Blood calcium level

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