Diagnostic and Management Problems of a Patient with Severe Life-Threatening Acute Hypocalcemia: A Case Report

Arvin Wiranata Lianto, Birgita Maria Ratu Rosari Bas, R. D. Adiwinoto, Libriansyah Libriansyah
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引用次数: 1

Abstract

Hypocalcemia is a common electrolyte disorder. Acute hypocalcemia is a life-threatening condition that needs prompt evaluation and management. We present a case of a 54-year-old woman presented to emergency room with muscle spasm and involuntary movement. Upon physical examination, the patient was disoriented and the Trousseau’s sign was bilaterally positive when the cuff was inflated. Blood test revealed severe hypocalcemia with albumin-corrected serum total calcium levels 1.77 mg/dL. Following extensive diagnostic workups, there were no alternative explanations other than vitamin D deficiency. Despite aggressive intravenous (IV) calcium correction and high-dose vitamin D supplementation the calcium levels gradually decreased and neurological symptoms relapsed. The use of phenytoin to treat neurological symptoms decreased calcium levels further. The patient was eventually discharged with oral calcium and calcitriol supplementation with minimal symptoms. This case highlights the importance of thorough diagnostic workups and judicious use of anticonvulsant drugs in hypocalcemia for optimal treatment outcome.
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1例严重危及生命的急性低钙血症的诊断和治疗问题
低钙血症是一种常见的电解质紊乱。急性低钙血症是一种危及生命的疾病,需要及时评估和处理。我们提出一个病例54岁的妇女提出了肌肉痉挛和不自主运动急诊室。经体格检查,患者迷失方向,当袖带充气时,双侧特鲁索氏征呈阳性。血液检查显示严重的低钙血症,白蛋白校正的血清总钙水平为1.77 mg/dL。经过广泛的诊断检查,除了维生素D缺乏之外,没有其他解释。尽管积极的静脉补钙和高剂量维生素D补充,钙水平逐渐下降,神经症状复发。使用苯妥英治疗神经系统症状进一步降低了钙水平。患者最终在口服补钙和骨化三醇后出院,症状轻微。本病例强调了彻底的诊断检查和明智地使用抗惊厥药物对低钙血症的最佳治疗结果的重要性。
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