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Dermatoses of Pregnancy
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Hannah J. Anderson, Dana Correale, Jason B. Lee
The most important complication is placental insufficiency and fetal death, the etiology of which is unknown [36, 57]. There may be hypocalcemia or decreased vitamin D levels as a result of hypoparathyroidism or hypoalbuminemia [36, 57, 59]. If severe, these changes may lead to tetany or seizure.
Hypoparathyroidism in pediatric patients
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Andrew C. Calabria, Michael A. Levine
For the acute management of symptomatic hypocalcemia in patients with tetany or cardiovascular manifestations, a slow intravenous injection of 10% calcium gluconate in a dose of 1 to 2 mL/kg up to 10 mL should be started. If tetany persists or recurs, additional intravenous calcium can be administered, preferably as a continuous infusion (1–3 mg/kg/h of elemental calcium). When a continuous infusion of calcium is not feasible, bolus infusions of calcium over several hours, every 6 to 8 hours, may be used, but care must be taken to avoid extravasation of calcium as its precipitation can cause tissue necrosis. Oral therapy with calcium and calcitriol should be instituted as soon as possible to allow discontinuation of intravenous calcium and can help in the transition to daily management of hypoparathyroidism.
Nutritional Disorders/Alternative Medicine
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Water, electrolyte, and element deficiencies are generally categorized as those involving either metabolic acidosis (loss of alkali) or alkalosis (acid defect). Specific acid-base disorders more closely related to nutrition are included in Table 20.2. Potassium deficiency or hypokalemia (hypo = less,-emia = blood) usually occurs from vomiting or diarrhea. A deficiency of calcium (hypocalcemia) is sometimes equated with the term tetany, muscular spasms with systemic effects. Other element deficiency disorders include hypophosphatemia, anemia (iron deficiency), and goiter (iodine deficiency).
Toxicity of phosphate enemas – an updated review
Published in Clinical Toxicology, 2022
Rosa Hamilton Smith, Michael Eddleston, D. Nicholas Bateman
In adults clinical details were provided in only five cases, four had hypotension [18,19,21,23] and two prolonged QT [21,22] although the QT values were not reported. Tetany was only reported in one adult patient [22]. In adults symptomatic hyperphosphataemia was associated with phosphate concentrations between 2.65 and 14.54 mmol/L (8.3–44.8 mg/dL) the highest upper limit of normal reported in the reports for adults being 1.55 mmol/L (4.8 mg/dL) (Table 1). Deaths occurred in patients with reported phosphate concentrations of 5.17, 4.26, 11.56, 14.54, 1.71, 3.07 and 9.69 mmol/L (16, 13.2, 38.8, 45.2, 5.3, 9.5 and 30 mg/dL respectively). Serum calcium concentrations ranged from 0.5 to 2.18 mmol/L (2–8.74 mg/dL) in adults, and deaths were in those with minimum calcium concentrations of 1.2, 1.1, 1.05, 0.5, 2.18, 2.08 and 0.93 mmol/L (4.81, 4.41, 4.21, 2, 8.74, 8.34 and 3.73 mg/dL) the lower limits for calcium quoted being 2–2.1 mmol/L (8–8.4 mg/dL) (Table 1). It seems from these data that neither absolute rise in phosphate nor fall in calcium are precise indicators of outcome.
Novel mutations of the SLC12A3 gene in patients with Gitelman syndrome
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Feng Wang, Manli Guo, Jing Li, Shaogang Ma
The symptoms are related to decreased serum potassium and magnesium levels and include muscle weakness, tetany, fatigue and palpitations. Knowledge of the serum and urine biochemical profile is vital to distinguish GS from a broad differential diagnosis, and the application of genetic testing can resolve difficult cases. Potassium and magnesium replacements are the cornerstone of treatment, although in practical terms, this replacement can be difficult for patients to manage and often does not fully relieve the symptoms, even when the serum levels are normalized. The lack of randomized controlled trials focusing on the treatment of this rare disease poses a challenge [1,2].
Pseudohypoparathyroidism type 1B – a rare cause of tetany: case report
Published in Paediatrics and International Child Health, 2018
Catarina Garcia, Cátia R. Correia, Lurdes Lopes
A 16-year-old adolescent presented with tetany, mostly while practicing sport, and was found to have severe hypocalcaemia and hyperphosphataemia. Genetic analysis demonstrated a methylation defect in the GNAS gene located on chromosome 20q13.32 (this complex locus encodes the α-subunit of the heterotrimeric G protein) confirming a diagnosis of PHP type 1B.