No abstract available.
Hypocalcemia*

No abstract available.
Basal Ganglia ; Hypocalcemia*

No abstract available.
Humans ; Hypocalcemia* ; Infant*

INTRODUCTION: Dengue is one of the causes of morbidity and mortality among pediatric patients. Calcium has been shown to play a role in the myocardial function of the patient and is a potential cause of mortality among dengue patients. This study aimed to determine the accuracy of hypocalcemia in predicting the severity of dengue among pediatric patients. METHODS: This is a systematic review and meta-analysis of published studies identified through an electronic literature search using PubMed/Medline, Cochrane Library, Herdin, Google Scholar, and hand search. Validity was assessed using the Cochrane risk of bias tool. Statistical analysis of the diagnostic test accuracy review was done using Review Manager 5.4.1 with the random effects model. Results showed sensitivity and specificity of hypocalcemia in severe dengue with a 95% confidence interval. The predictive values and likelihood ratios were also computed. RESULTS: Four studies were analyzed. The mean serum total and ionized calcium levels of patients were decreased among the severe dengue group. Data showed that there is a 74% sensitivity (95% CI = 0.58, 0.84) and 75% specificity (95% CI = 0.67, 0.81) with a positive predictive value of 67% and a negative predictive value of 90.7%. CONCLUSION This systematic review and meta-analysis showed that hypocalcemia may be a useful tool to predict severe dengue fever. However, further analysis is needed to strengthen the the diagnostic accuracy of hypocalcemia.
Severe Dengue ; Hypocalcemia

Objective: To determine the association of surgeon’s experience based on years of practice and incidence of post thyroidectomy hypocalcemia. Methods: Design: Retrospective cohort study. Setting: Tertiary Private Training Hospital. Participants: Records of patients who underwent total thyroidectomy in a private tertiary hospital from January 2003 to December 2018 were retrospectively reviewed. Medical information obtained were patient demographics, surgeon’s years of practice, thyroid specimen weight, technique of surgery, histopathologic findings and calcium assay values. Chi square test and Odds Ratio analysis were used to determine the relationship between the surgeon’s experience and post-thyroidectomy hypocalcemia. Results: Three hundred fourteen (314) patients who underwent total thyroidectomy from 2003 to 2018 were included in the study. Overall rate of post-operative hypocalcemia was 41%. On multivariate analysis, no significant odds ratio was found between surgeons with 5 to 19 years of experience and those with more than 19 years of experience in relation to post-operative hypocalcemia [Odds Ratio 1.4 (95% Confidence Interval 0.7 to 2.6)]. Odds ratios for other variables may be interpreted, however, they could not be generalized over the population where data was gathered since the 95% Confidence Interval includes 1. Conclusion The results of this retrospective cohort study suggest that post-thyroidectomy hypocalcemia is not associated with surgeon’s experience based on years of practice. Further studies are recommended in a multicenter approach to better generalize to the whole population.
Thyroidectomy ; Hypocalcemia ; Postoperative Complications

There are diverse neurologic manifestations in patients with idiopathic or pseudohypoparathyroidism. Although one knows that hypocalcemia provokes symptoms of tetany, there is little knowldege about the paroxysmal dystonic choreoathetosis(PKC). We report two patients with paroxysmal symptoms resulting from hypocalcemia associated with idiopathic hypoparathyroidism and pseudohypoparathryoidism respectively, which were misdiagnosed and treated as epilepsy. They showed repetitive paroxysmal dystonic choreoathetotic movements that lasted for several seconds and typically induced by sudden voluntary movement. The ne-uroimaging showed bilateral symmetrical calcifications., mainly in the basal ganglia. In the clinical setting, these types of paroxysmal movements may be readily misdiagnosed as partial seizure or tetany. Therefore, not only the laboratory work up for hypocalcemia, but careful history taking and clinical observation is important in differential diagnosis of epilepsy and paroxysmal movements in the patient with hypocalcemia.
Basal Ganglia ; Diagnosis, Differential ; Epilepsy ; Humans ; Hypocalcemia ; Hypoparathyroidism* ; Neurologic Manifestations ; Pseudohypoparathyroidism ; Seizures ; Tetany

PURPOSE: To describe the clinical characteristics of full-term neonates with hypocalcemia and to suggest factors associated with neonatal hypocalcemia METHODS: The medical records of full-term neonates with hypocalcemia were reviewed. Hypocalcemia was defined as an ionized calcium (iCa) concentration of <4 mg/dL. Parathyroid hormone (PTH) insufficiency was defined as a serum PTH level of <60 pg/mL or a serum phosphorus level higher than the serum calcium level in the presence of hypocalcemia. RESULTS: Fifty-three neonates were enrolled. The median age at diagnosis of hypocalcemia was 3 days. In all the neonates, formula feeding predominance was observed. Thirty-eight neonates (69.8%) were compatible with PTH insufficiency. The number of formula-fed neonates was significantly higher than that of breast-fed patients among neonates with PTH insufficiency (P=0.017). Intact PTH was negatively correlated with serum phosphorus levels. Twelve out of 14 neonates (85.7%) had 25-hydroxy vitamin D (25OHD) levels <20 ng/mL and 9 neonates (64.3%) had 25OHD levels <10 ng/mL. Twenty-one neonates had hypocalcemic tetany. The serum calcium and iCa concentrations of neonates with tetany were 4.2-8.3 mg/dL and 1.85-3.88 mg/dL, respectively. Three neonates showed symptomatic hypocalcemia with calcium levels over 7.5 mg/dL. Among the 16 neonates who underwent electroencephalography (EEG), 12 had abnormalities, which normalized after 1-2 months. CONCLUSION: Formula milk feeding, PTH insufficiency and low serum vitamin D concentration are associated with the development of neonatal hypocalcemia. Symptoms such as tetany and QT interval prolongation can develop in relatively mild hypocalcemia. Moreover, transient neonatal hypocalcemia can cause transient EEG abnormalities.
Calcium ; Diagnosis ; Electroencephalography ; Humans ; Hypocalcemia* ; Infant, Newborn ; Medical Records ; Milk ; Parathyroid Hormone ; Phosphorus ; Tetany ; Vitamin D

No abstract available.
Humans ; Hypocalcemia* ; Infant, Newborn ; Prognosis*

Hyperparathyroidism is a common finding in patients with chronic renal failure. Among the hyperparathyroidism, tertiary hyperparathyroidism, which is secreting parathyroid hormone autonomously in spite of hypercalcemia. Sometimes it requires surgical intervention due to not only symptomatic hypercalcemia, but also longstanding asymptomatic hypercalcemia. Hungry bone syndrome was known to be developed due to extensive re-mineralization of skeleton after parathyroidectomy. It is characteristic of persistent hypocalcemia, hypophosphatemia and often with tetany. The patient's condition improved without complication after the calcium chloride and calcium carbonate administration. We report a case of hungry bone syndrome developed after parathyroidectomy in patient with tertiary hyperparathyroidism and chronic renal failure.
Calcium Carbonate ; Calcium Chloride ; Humans ; Hypercalcemia ; Hyperparathyroidism* ; Hypocalcemia ; Hypophosphatemia ; Kidney Failure, Chronic ; Parathyroid Hormone ; Parathyroidectomy* ; Renal Dialysis* ; Skeleton ; Tetany

Oral sodium phosphate (NaP) is increasingly used to prepare patients for gastrointestinal procedures such as colonoscopy. Severe hyperphosphatemia may complicate bowel-cleansing preparation using oral NaP. The risk of hyperphosphatemia is known to increase with excessive and/or repeated doses, increased intestinal absorption, or impaired renal excretion of phosphate. Hyperphosphatemia may produce acute renal failure, but the mechanism is not yet clear. Some authors suggest that renal injury is caused by intrarenal calcium-phosphate deposition, but others suggest that direct tubular toxicity or a disturbance in renal hemodynamics may induce renal injury. A 74-year-old woman was admitted with generalized weakness after taking NaP for colonoscopy. She had no underlying diseases such as renal disease. She was hypotensive and had carpopedal spasm with hypocalcemia, severe hyperphosphatemia, metabolic acidosis, and non-oliguric acute renal failure. She was treated with aggressive hydration, calcium replacement and aluminum-containing antacid, but hyperphosphatemia was aggravated (35.6 mg/ dL). Hemodialysis was done and phophate concentration was lowered to 5.5 mg/dL. It is suggested that caution should be taken when using phosphate- containing laxatives especially for elderly patients even if they have no underlying diseases.
Acidosis ; Acute Kidney Injury ; Aged ; Calcium ; Colonoscopy ; Female ; Hemodynamics ; Humans ; Hyperphosphatemia* ; Hypocalcemia ; Intestinal Absorption ; Laxatives ; Renal Dialysis ; Sodium* ; Spasm ; Tetany*