71. Hypocalcemia: Definition, Etiology, Pathogenesis, Diagnosis, and Management

  1. Clifford J. Rosen MD
  1. Anne L. Schafer and
  2. Dolores Shoback

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch71

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Schafer, A. L. and Shoback, D. (2013) Hypocalcemia: Definition, Etiology, Pathogenesis, Diagnosis, and Management, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch71

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • hypocalcemia;
  • hypophosphatemia;
  • parathyroid hormone (PTH)

Summary

Hypocalcemia, defined as an ionized calcium (Ca2+) concentration that falls below the lower limit of the normal range, is a commonly encountered clinical problem with multiple causes. It is imperative that the clinician establishes that the ionized Ca2+ concentration is indeed reduced, before an exhaustive search for an etiology of hypocalcemia. Recent reports indicate that the tyrosine kinase inhibitor imatinib mesylate, used to treat chronic myeloid leukemia and gastrointestinal stromal tumors, can cause both hypocalcemia and hypophosphatemia, likely due to its direct skeletal effects. Careful management and repeated mineral and parathyroid hormone (PTH) analyses will usually allow the diagnosis to become clear over time. The goals of treatment are to alleviate symptoms, heal demineralized bones when osteomalacia is present, maintain an acceptable ionized Ca2+ or total serum Ca2+, and avoid hypercalciuria.