Disorders of calcium metabolism: Difference between revisions

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'''Disorders of Calcium Metabolism''' are a group of conditions that affect the balance and regulation of calcium in the body. Calcium is a vital mineral necessary for many bodily functions, including bone formation, muscle function, and nerve transmission. Abnormalities in calcium metabolism can lead to various clinical manifestations, ranging from asymptomatic laboratory findings to life-threatening conditions.
{{SI}}
 
{{Infobox medical condition
==Etiology==
| name            = Disorders of calcium metabolism
Disorders of calcium metabolism can arise from several causes, including:
| image          = [[File:Ca-TableImage.svg|250px]]
* [[Endocrine disorders]], such as [[hyperparathyroidism]] and [[hypoparathyroidism]], which affect the parathyroid glands' regulation of calcium.
| caption        = Calcium is a vital mineral in the body, and its metabolism is crucial for various physiological functions.
* [[Vitamin D deficiency]] or disorders in vitamin D metabolism, impacting calcium absorption from the gut.
| field          = [[Endocrinology]]
* [[Renal failure]], leading to changes in calcium and phosphate handling.
| symptoms        = [[Muscle cramps]], [[tetany]], [[osteoporosis]], [[kidney stones]], [[neurological symptoms]]
* Genetic conditions, such as [[familial hypocalciuric hypercalcemia]] (FHH) and [[autosomal dominant hypocalcemia]].
| complications  = [[Cardiac arrhythmias]], [[osteomalacia]], [[nephrocalcinosis]]
 
| onset          = Varies depending on the specific disorder
==Pathophysiology==
| duration        = Chronic or acute
The regulation of calcium levels in the body is a complex process involving the [[bones]], [[kidneys]], and [[gastrointestinal tract]], under the control of parathyroid hormone (PTH), vitamin D, and the calcitonin hormone. Disorders in any of these regulatory mechanisms can lead to disturbances in calcium metabolism.
| causes          = [[Hypoparathyroidism]], [[hyperparathyroidism]], [[vitamin D deficiency]], [[renal failure]], [[malabsorption]]
 
| risks          = [[Genetic predisposition]], [[dietary factors]], [[medications]]
===Hypercalcemia===
| diagnosis      = [[Serum calcium test]], [[parathyroid hormone levels]], [[vitamin D levels]], [[bone density scan]]
Hypercalcemia refers to elevated calcium levels in the blood. It can result from increased intestinal absorption, increased bone resorption, or decreased renal excretion of calcium. Common causes include hyperparathyroidism, malignancy, and vitamin D intoxication.
| differential    = [[Hypocalcemia]], [[hypercalcemia]], [[osteoporosis]], [[Paget's disease of bone]]
 
| treatment      = [[Calcium supplements]], [[vitamin D therapy]], [[bisphosphonates]], [[parathyroidectomy]]
===Hypocalcemia===
| medication      = [[Calcitriol]], [[calcium carbonate]], [[alendronate]]
Hypocalcemia is characterized by low levels of calcium in the blood. It can occur due to inadequate calcium intake, impaired calcium absorption, or excessive calcium loss. Causes include hypoparathyroidism, vitamin D deficiency, and renal disease.
| prognosis      = Varies; depends on underlying cause and treatment
 
| frequency      = Common, especially in older adults
==Clinical Manifestations==
}}
Symptoms of calcium metabolism disorders vary widely and depend on the severity and rate of change of blood calcium levels.
Disorders of calcium metabolism are a group of medical conditions that affect the regulation of calcium levels in the body. Calcium is an essential mineral that plays a critical role in various physiological processes, including bone formation, muscle contraction, nerve function, and blood clotting. The balance of calcium in the body is tightly regulated by the [[parathyroid hormone]] (PTH), [[vitamin D]], and the kidneys.
 
== Calcium Homeostasis ==
===Hypercalcemia===
Calcium homeostasis refers to the maintenance of a stable concentration of calcium ions in the blood and extracellular fluid. The normal serum calcium level is approximately 8.5 to 10.5 mg/dL. The regulation of calcium involves:
Symptoms of hypercalcemia may include polyuria, polydipsia, kidney stones, nausea, vomiting, constipation, muscle weakness, and cognitive disturbances.
* '''Parathyroid Hormone (PTH):''' Secreted by the [[parathyroid glands]], PTH increases blood calcium levels by stimulating osteoclasts to break down bone, increasing renal tubular reabsorption of calcium, and activating vitamin D.
 
* '''Vitamin D:''' Enhances intestinal absorption of calcium and phosphate.
===Hypocalcemia===
* '''Calcitonin:''' Secreted by the [[thyroid gland]], it lowers blood calcium levels by inhibiting osteoclast activity.
Hypocalcemia can present with neuromuscular irritability, including tetany (involuntary muscle contraction), seizures, prolonged QT interval on ECG, and psychiatric manifestations.
== Types of Disorders ==
 
=== Hypercalcemia ===
==Diagnosis==
[[Hypercalcemia]] is a condition characterized by an abnormally high level of calcium in the blood. Common causes include:
Diagnosis of calcium metabolism disorders involves a thorough history, physical examination, and laboratory tests. Key laboratory tests include serum calcium, phosphate, magnesium, PTH, and vitamin D levels. Additional tests, such as urinary calcium excretion, may be necessary to determine the underlying cause.
* '''Primary Hyperparathyroidism:''' Overactivity of one or more of the parathyroid glands.
 
* '''Malignancy:''' Certain cancers can cause hypercalcemia through bone metastasis or secretion of parathyroid hormone-related peptide (PTHrP).
==Treatment==
* '''Vitamin D Toxicity:''' Excessive intake of vitamin D supplements.
Treatment of disorders of calcium metabolism aims to correct the underlying cause and restore calcium balance.
Symptoms of hypercalcemia can include nausea, vomiting, constipation, polyuria, polydipsia, confusion, and in severe cases, cardiac arrhythmias.
 
=== Hypocalcemia ===
===Hypercalcemia===
[[Hypocalcemia]] is defined as a low level of calcium in the blood. Causes include:
Treatment options for hypercalcemia may include hydration, bisphosphonates, calcitonin, and in severe cases, dialysis.
* '''Hypoparathyroidism:''' Reduced secretion of PTH.
 
* '''Vitamin D Deficiency:''' Due to inadequate dietary intake, lack of sunlight, or malabsorption.
===Hypocalcemia===
* '''Chronic Kidney Disease:''' Impaired conversion of vitamin D to its active form.
Hypocalcemia treatment typically involves calcium supplementation and vitamin D therapy. In acute cases, intravenous calcium may be required.
Symptoms of hypocalcemia may include muscle cramps, tetany, seizures, and cardiac arrhythmias.
 
== Diagnosis ==
==Prevention==
The diagnosis of calcium metabolism disorders involves:
Preventive measures for disorders of calcium metabolism focus on adequate intake of calcium and vitamin D, regular exercise, and monitoring in individuals at risk.
* '''Serum Calcium Measurement:''' Total and ionized calcium levels.
 
* '''PTH Levels:''' To assess parathyroid function.
==Conclusion==
* '''Vitamin D Levels:''' To evaluate vitamin D status.
Disorders of calcium metabolism encompass a wide range of conditions with diverse etiologies and clinical manifestations. Early recognition and appropriate management are crucial to prevent complications and improve outcomes.
* '''Renal Function Tests:''' To assess kidney function.
 
== Treatment ==
[[Category:Endocrinology]]
Treatment of calcium metabolism disorders depends on the underlying cause:
[[Category:Metabolic disorders]]
* '''Hypercalcemia:''' May require hydration, diuretics, bisphosphonates, or calcitonin.
{{medicine-stub}}
* '''Hypocalcemia:''' Treated with calcium supplements and vitamin D.
== See also ==
* [[Calcium in biology]]
* [[Parathyroid hormone]]
* [[Vitamin D]]
* [[Bone metabolism]]
{{Disorders of calcium metabolism}}
[[Category:Endocrine disorders]]
[[Category:Calcium]]

Latest revision as of 18:20, 5 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Disorders of calcium metabolism
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Muscle cramps, tetany, osteoporosis, kidney stones, neurological symptoms
Complications Cardiac arrhythmias, osteomalacia, nephrocalcinosis
Onset Varies depending on the specific disorder
Duration Chronic or acute
Types N/A
Causes Hypoparathyroidism, hyperparathyroidism, vitamin D deficiency, renal failure, malabsorption
Risks Genetic predisposition, dietary factors, medications
Diagnosis Serum calcium test, parathyroid hormone levels, vitamin D levels, bone density scan
Differential diagnosis Hypocalcemia, hypercalcemia, osteoporosis, Paget's disease of bone
Prevention N/A
Treatment Calcium supplements, vitamin D therapy, bisphosphonates, parathyroidectomy
Medication Calcitriol, calcium carbonate, alendronate
Prognosis Varies; depends on underlying cause and treatment
Frequency Common, especially in older adults
Deaths N/A


Disorders of calcium metabolism are a group of medical conditions that affect the regulation of calcium levels in the body. Calcium is an essential mineral that plays a critical role in various physiological processes, including bone formation, muscle contraction, nerve function, and blood clotting. The balance of calcium in the body is tightly regulated by the parathyroid hormone (PTH), vitamin D, and the kidneys.

Calcium Homeostasis[edit]

Calcium homeostasis refers to the maintenance of a stable concentration of calcium ions in the blood and extracellular fluid. The normal serum calcium level is approximately 8.5 to 10.5 mg/dL. The regulation of calcium involves:

  • Parathyroid Hormone (PTH): Secreted by the parathyroid glands, PTH increases blood calcium levels by stimulating osteoclasts to break down bone, increasing renal tubular reabsorption of calcium, and activating vitamin D.
  • Vitamin D: Enhances intestinal absorption of calcium and phosphate.
  • Calcitonin: Secreted by the thyroid gland, it lowers blood calcium levels by inhibiting osteoclast activity.

Types of Disorders[edit]

Hypercalcemia[edit]

Hypercalcemia is a condition characterized by an abnormally high level of calcium in the blood. Common causes include:

  • Primary Hyperparathyroidism: Overactivity of one or more of the parathyroid glands.
  • Malignancy: Certain cancers can cause hypercalcemia through bone metastasis or secretion of parathyroid hormone-related peptide (PTHrP).
  • Vitamin D Toxicity: Excessive intake of vitamin D supplements.

Symptoms of hypercalcemia can include nausea, vomiting, constipation, polyuria, polydipsia, confusion, and in severe cases, cardiac arrhythmias.

Hypocalcemia[edit]

Hypocalcemia is defined as a low level of calcium in the blood. Causes include:

  • Hypoparathyroidism: Reduced secretion of PTH.
  • Vitamin D Deficiency: Due to inadequate dietary intake, lack of sunlight, or malabsorption.
  • Chronic Kidney Disease: Impaired conversion of vitamin D to its active form.

Symptoms of hypocalcemia may include muscle cramps, tetany, seizures, and cardiac arrhythmias.

Diagnosis[edit]

The diagnosis of calcium metabolism disorders involves:

  • Serum Calcium Measurement: Total and ionized calcium levels.
  • PTH Levels: To assess parathyroid function.
  • Vitamin D Levels: To evaluate vitamin D status.
  • Renal Function Tests: To assess kidney function.

Treatment[edit]

Treatment of calcium metabolism disorders depends on the underlying cause:

  • Hypercalcemia: May require hydration, diuretics, bisphosphonates, or calcitonin.
  • Hypocalcemia: Treated with calcium supplements and vitamin D.

See also[edit]

Template:Disorders of calcium metabolism

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