Hypocalcemia

Normal concentration of calcium in a blood plasma of the person makes 2,2 – 2,5 mmol/l. At its decrease lower than 1,87 mmol/l the morbid condition called by a hypocalcemia develops.

Hypocalcemia reasons:

• Hypoparathyrosis. At long ischemia of epithelial bodies, their hypoplasia or removal there is a sharp decrease in content in blood of the parathormone necessary for maintenance at the physiological level of content in plasma of calcium ions. As a result of it excess removal of calcium is stimulated with kidneys and release of this element from a bone tissue is slowed down;
• Hypovitaminosis of D. At this state processes of absorption of calcium in intestines, and also its exchange in a bone tissue are broken that is the reason of a hypocalcemia.
• Hypersecretion of the antagonist of parathormone – thyrocalcitonin;
• Some diseases of intestines (sprue, resection of the site of a small intestine, chronic enteritis) at which absorption by a mucous membrane of a small bowel of calcium is broken;
• Acholia – the termination of receipt in a small intestine of the bile necessary for normal course of processes of membrane and band digestion, and also for vitamin D metabolism;
• Noncompensated chronic alkalosis. In this case because of the raised pH of a blood plasma there is an active linkng of calcium ions with proteins that is the reason of a hypocalcemia;
• Hypomagnesiemia. Deficit of magnesium in a blood plasma leads to decrease in secretion by parathormone epithelial bodies. In addition, at a hypomagnesiemia biological activity of vitamin D and parathormone in a bone tissue also decreases;
• Hypoalbuminemia (the lowered contents in a protein blood plasma). The hypocalcemia reason in this case is that there is a decrease in concentration of the general level of serumal calcium at the expense of its fractions connected with albumine.

Hypocalcemia: symptoms

The hypocalcemia is usually combined with a hyperpotassemia that leads to emergence of a hyperexcitability of muscle and nervous cells, and also increases the speed of carrying out excitement in them. Increase in neuromuscular excitability is shown by developing of tetanic spasms which can affect various groups of muscles (mimic, throats, brushes, legs, etc.). At easy degrees of a hypocalcemia the latent tetany is observed. It is characterized by positive symptoms of Trusso (when pressing on muscles of a shoulder there are brush myotonia) and/or Hvosteka (spasms of mimic muscles at irritation of a branch of a facial nerve). Symptoms of a hypocalcemia are also various disturbances of skin sensitivity (numbness, a pricking, burning).

Other symptoms of a hypocalcemia are:

• Hemorrhagic and hypocoagulative syndromes. They are shown by the raised bleeding because of decrease in coagulability of blood. Their development is explained by the fact that the lack of calcium increases permeability of walls of blood vessels. In addition, this chemical element is necessary for activation of some factors of coagulant system of blood.
• Dystrophic changes of the fabrics which are ectoderm derivatives. They are shown by various defects of teeth, the increased fragility of nails and hair, a xeroderma, development of a cataract.
• Disturbances of a cordial rhythm.

Hypocalcemia at children

The deficit of calcium leading to development of a hypocalcemia can be observed at children of any age. Very often leads a lack of a diet of calcium and phosphorus, vitamin D to development in them of this morbid condition. In addition the hypocalcemia at children can be caused also by any other reason from listed above.

The hypocalcemia at children is usually shown by a triad of symptoms:

• Carpopedal spasm. At it brushes adopt the characteristic provision called by "obstetrical hand";
• Stridor (noisy, goose breathing). Results from a laryngospasm;
• Convulsive syndrome.

At a hypocalcemia at children the carpopedal syndrome is more often observed, and here the stridor and spasms are much more rare.

Hypocalcemia: treatment

At a hypocalcemia it is necessary not only to fill the available shortage of calcium, but also to try to remove whenever possible the cause which led to development of this morbid condition.

At a hypoparathyrosis appoint replacement hormonal therapy. At tetany attacks against the background of an acute hypocalcemia intravenously enter solution of chloride or a gluconate of calcium. For treatment of a hypocalcemia in a chronic form sick appoint vitamin D (calcitriol, ergocalciferol) and calcium drugs in tablets (a calcium gluconate, calcium carbonate). In the presence of a dekompensirovanny alkalosis carrying out measures for correction of KShchS of blood is necessary.

Also at treatment of a hypocalcemia it is important to normalize the level of potassium, magnesium and protein in a blood plasma. If necessary adequate therapy of the digestive tract diseases which are available for the patient is appointed.