Normally, the calcium concentration in human plasma is 2, 2 - 2, 5 mmol / l. When it drops below 1, 87 mmol / l developing a pathological condition known as hypocalcemia.
Causes of hypocalcemia:
- Hypoparathyroidism. During prolonged ischemia parathyroid hypoplasia blocked or removed, a sharp reduction in the blood levels of parathyroid hormone required to maintain the contents at the physiological level of calcium ions in the plasma. As a result, excessive stimulated calcium excretion by the kidneys and slows down the release of the element from the bone tissue;
- Gipovitaminoz D. In this state, the broken processes intestinal calcium absorption as well as its metabolism in bone tissues that is a cause hypocalcemia.
- Increased secretion of parathyroid hormone antagonist - calcitonin;
- Some bowel disease (malabsorption syndrome, resection of the area of the small intestine, chronic enteritis), in which disrupted the absorption of the mucosa of the small intestine of calcium;
- Ahola - prevention of bile into the small intestine, necessary for the normal processes of the membrane cavity and digestion, as well as the metabolism of vitamin D;
- Uncompensated chronic alkalosis. In this case, due to high pH is an active blood plasma binding of calcium ions with the protein that is the cause hypocalcemia;
- Hypomagnesemia. Magnesium deficiency in plasma reduces the secretion of PTH parathyroid glands. In addition, when hypomagnesemia are also reduced the biological activity of vitamin D, and parathyroid hormone in bone tissue;
- Hypoalbuminemia (low plasma protein). The cause hypocalcemia in this case is that there is a decrease in serum concentrations of total calcium due to its fractions associated with albumin.
Hypocalcemia is usually associated with hyperkalemia which leads to increased excitability of nerve and muscle cells and increases in the speed of their excitation. Increased neuromuscular excitability seen the emergence of tetanic seizures, which may affect different groups of muscles (facial, throat, hands, feet, etc.). Mild hypocalcemia observed latent tetany. It is characterized by positive symptoms Trousseau (with pressure on the muscles of the shoulder muscle cramps occur brushes) and / or chvostek (spasms of facial muscles during stimulation of the facial nerve branches). Also, symptoms of hypocalcemia are also various disorders of skin sensitivity (numbness, tingling, burning sensation).
Other symptoms of hypocalcemia are:
- Hemorrhagic and hypocoagulation syndromes. They manifest bleeding disorders due to lower blood clotting. Their development is explained by the fact that calcium deficiency increases the permeability of blood vessel walls. In addition, this chemical element is required to activate certain clotting factors.
- Degenerative changes of tissues, which are derived from the ectoderm. They exhibit various defects of teeth, increased fragility of hair and nails, dry skin, the development of cataracts.
- Cardiac arrhythmias.
Hypocalcemia in children
Calcium deficiency, leading to the development of hypocalcemia can occur in children of any age. Very often they have to develop a pathological condition that results in a lack of dietary calcium and phosphorous, vitamin D. Furthermore hypocalcemia in children may be due to any other cause of the above.
Hypocalcemia in children usually manifests by a triad of symptoms:
- Karpopedalny spasm. During his hand take the position of a characteristic called "hand obstetrician";
- Stridor (noisy, wheezing). It arises as a result of spasm of the glottis;
- Spastic syndrome.
If hypocalcemia is more common in children karpopedalny syndrome, but stridor and seizures are much rarer.
If hypocalcemia is necessary not only to fill the existing shortage of calcium, but try as much as possible to eliminate the causes that led to the development of the disease state.
When hypoparathyroidism prescribed hormone replacement therapy. In attacks of tetany hypocalcemia on the background of the acute intravenous sodium chloride or calcium gluconate. For the treatment of hypocalcemia in patients with chronic administered vitamin D (calcitriol, ergocalciferol) and calcium tablets (calcium gluconate, calcium carbonate). In the presence of decompensated alkalosis necessary to carry out measures for correction of acid-base balance of blood.
Also important in the treatment of hypocalcemia normalize levels of potassium, magnesium, and protein in blood plasma. If you need to assign adequate therapy available to the patient's gastrointestinal tract.