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Approach

  1. Is this real hypo-calcemia?

    1. What is the adjusted Ca based on Albumin (40)

      <aside> 💡 Corrected Ca = measured Ca + 0.02 * (40 - measured Albumin)

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  2. How severe is the hypo-calcemia

    1. Severe symptom → IV calcium
    2. Mild symptom → PO calcium
    3. *Rhabdo: don’t give Ca
  3. Find out the etiology

Blood Work Result

Condition Ca²⁺ PO₄³⁻ PTH
↓↓↓ irrelevant ↓↓↓
Autoimmune Hypoparathyroidism ↓↓↓ ↑↑↑ ↓↓↓
Vitamin D Deficiency (dietary, malabsorption, liver/kidney disease) ↓ or normal (PTH still there)
↑ (Kidney NOT function)
↓ (Sequester) Normal or ↓
↑ (appro. response)

DDx

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Signs and Symptoms

Symptoms

Signs