Hypocalcemia/Hypercalcemia

aciltip-10-2-kapak-wos

Burhan Burak KUZUCUa , Havva ŞAHİN KAVAKLIa

aAnkara Bilkent City Hospital, Clinic of Emergency Medicine, Ankara, Türkiye

ABSTRACT
Calcium serves as the most abundant extracellular cation in the human body, primarily constituting the main component of bones and teeth. Approximately 99% of the body’s calcium is found in bones, providing essential structural support. The remaining 1% circulates in the bloodstream, where the normal calcium concentration ranges from 8.5-10.5 mg/dL. In addition to maintaining bone structure, calcium also functions as a secondary messenger. It plays a crucial role in relaying signals from cell surface receptors to intracellular systems. Moreover, calcium participates in the clotting cascade by activating platelets and coagulation factors like thrombin and factor XIII. It contributes to muscle contraction by binding to troponin C on actin filaments and modulating myosin filaments through calmodulin. The regulation of calcium balance in the body involves three key factors: calcitonin, vitamin D, and parathyroid hormone (PTH). PTH, secreted by the parathyroid glands located near the thyroid gland, acts as the primary regulator of calcium through negative feedback mechanisms in the body.
Keywords: Hypocalcemia; hypercalcemia; endocrine emergencies

Referanslar

  1. Basso SM, Lumachi F, Nascimben F, Luisetto G, Camozzi V. Treatment of acute hypercalcemia. Med Chem. 2012;8(4):564-8. [Crossref]  [PubMed]
  2. Peacock M. Calcium metabolism in health and disease. Clin J Am Soc Nephrol. 2010;5 Suppl 1:S23-30. [Crossref]  [PubMed]
  3. Bove-Fenderson E, Mannstadt M. Hypocalcemic disorders. Best Pract Res Clin Endocrinol Metab. 2018;32(5):639-56. [Crossref]  [PubMed]
  4. Canu GL, Medas F, Longheu A, Boi F, Docimo G, Erdas E, Calò PG. Correlation between iPTH Levels on the First Postoperative Day After Total Thyroidectomy and Permanent Hypoparathyroidism: Our Experience. Open Med (Wars). 2019;14:437-42. [Crossref]  [PubMed]  [PMC]
  5. Bilezikian JP, Brandi ML, Cusano NE, Mannstadt M, Rejnmark L, Rizzoli R, et al. Management of Hypoparathyroidism: Present and Future. J Clin Endocrinol Metab. 2016;101(6):2313-24. [Crossref]  [PubMed]  [PMC]
  6. Riccardi D, Brown EM. Physiology and pathophysiology of the calcium-sensing receptor in the kidney. Am J Physiol Renal Physiol. 2010;298(3):F485-99. [Crossref]  [PubMed]  [PMC]
  7. Li K, Xu Y. Citrate metabolism in blood transfusions and its relationship due to metabolic alkalosis and respiratory acidosis. Int J Clin Exp Med. 2015;8(4):6578-84.
  8. Marcucci G, Cianferotti L, Brandi ML. Clinical presentation and management of hypoparathyroidism. Best Pract Res Clin Endocrinol Metab. 2018;32 (6):927-39. [Crossref]  [PubMed]
  9. Bollerslev J, Pretorius M, Heck A. Parathyroid hormone independent hypercalcemia in adults. Best Pract Res Clin Endocrinol Metab. 2018;32(5):621-38. [Crossref]  [PubMed]
  10. Goldner W. Cancer-Related Hypercalcemia. J Oncol Pract. 2016;12(5):426-32. [Crossref]  [PubMed]
  11. Heemskerk CPM, Pereboom M, van Stralen K, Berger FA, van den Bemt PMLA, Kuijper AFM, et al. Risk factors for QTc interval prolongation. Eur J Clin Pharmacol. 2018;74(2):183-91. [Crossref]  [PubMed]
  12. Hujoel IA. The association between serum calcium levels and Chvostek sign: A population-based study. Neurol Clin Pract. 2016;6(4):321-8. [Crossref]  [PubMed]  [PMC]
  13. Magnotti LJ, Bradburn EH, Webb DL, Berry SD, Fischer PE, Zarzaur BL, et al. Admission ionized calcium levels predict the need for multiple transfusions: a prospective study of 591 critically ill trauma patients. J Trauma. 2011;70(2): 391-5; discussion 395-7. [Crossref]  [PubMed]
  14. Singer AJ, Thode HC Jr, Peacock WF. A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes. Clin Exp Emerg Med. 2017;4(2):73-79. [Crossref]  [PubMed]  [PMC]
  15. Hannan FM, Thakker RV. Investigating hypocalcaemia. BMJ. 2013;346:f2213. [Crossref]  [PubMed]
  16. Kelly A, Levine MA. Hypocalcemia in the critically ill patient. J Intensive Care Med. 2013;28(3):166-77. [Crossref]  [PubMed]
  17. Clusin WT. Calcium and cardiac arrhythmias: DADs, EADs, and alternans. Crit Rev Clin Lab Sci. 2003;40(3):337-75. Erratum in: Crit Rev Clin Lab Sci. 2004;41(1):115. [Crossref]  [PubMed]
  18. Hammond DA, Stojakovic J, Kathe N, Tran J, Clem OA, Erbach K, et al. Effectiveness and Safety of Magnesium Replacement in Critically Ill Patients Admitted to the Medical Intensive Care Unit in an Academic Medical Center: A Retrospective, Cohort Study. J Intensive Care Med. 2019;34(11-12):967-72. [Crossref]  [PubMed]
  19. Acharya R, Winters DM, Rowe C, Buckley N, Kafle S, Chhetri B. An unusual case of severe hypercalcemia: as dehydrated as a bone. J Community Hosp Intern Med Perspect. 2021;11(1):135-8. [Crossref]  [PubMed]  [PMC]
  20. Eastell R, Brandi ML, Costa AG, D'Amour P, Shoback DM, Thakker RV. Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab. 2014;99(10):3570-9. Erratum in: J Clin Endocrinol Metab. 2015;100 (5):2137. [Crossref]  [PubMed]
  21. Yu N, Donnan PT, Murphy MJ, Leese GP. Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin Endocrinol (Oxf). 2009;71(4):485-93. [Crossref]  [PubMed]
  22. Dellay B, Groth M. Emergency Management of Malignancy-Associated Hypercalcemia. Adv Emerg Nurs J. 2016;38(1):15-25; quiz E1. [Crossref]  [PubMed]
  23. Ralston SH. Medical management of hypercalcaemia. Br J Clin Pharmacol. 1992;34(1):11-20. [Crossref]  [PubMed]  [PMC]
  24. Turner JJO. Hypercalcaemia - presentation and management . Clin Med (Lond). 2017;17(3):270-3. [Crossref]  [PubMed]  [PMC]
  25. Clines GA, Guise TA. Hypercalcaemia of malignancy and basic research on mechanisms responsible for osteolytic and osteoblastic metastasis to bone. Endocr Relat Cancer. 2005;12(3):549-83. [Crossref]  [PubMed]
  26. Walsh J, Gittoes N, Selby P; Society for Endocrinology Clinical Committee. Society For Endocrinology Endocrine Emergency Guidance: Emergency management of acute hypercalcaemia in adult patients. Endocr Connect. 2016;5(5):G9-G11. [Crossref]  [PubMed]  [PMC]
  27. Sabry NA, Habib EE. Zoledronic acid and clodronate in the treatment of malignant bone metastases with hypercalcaemia; efficacy and safety comparative study. Med Oncol. 2011;28(2):584-90. [Crossref]  [PubMed]