Hypocalcemia causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

Hypocalcemia can be the consequence of multiple disease processes, some of which will be mentioned in the following discussion. Common causes of hypocalcemia include vitamin D insufficiency, hypoparathyroidism, renal disease, pseudohypoparathyroidism, hypomagnesemia, drugs and Fanconi syndrome etc.

Causes

Common Causes

Common causes of hypocalcemia may include:^[1]

Vitamin D insufficiency
Hypoparathyroidism
Renal disease
Pseudohypoparathyroidism
Drugs like bisphosphonates
Heavy metal (copper, iron)

Less Common Causes

Lessn common causes of hypocalcemia may include:^[2]

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	Alcohol abuse
Dermatologic	No underlying causes
Drug Side Effect	Anticonvulsant therapy, Cabozantinib, Capreomycin sulfate, Chelation therapy, Cinacalcet, Conjugated estrogens/bazedoxifene, Cytarabine, Dactinomycin, Diuretic therapy, Drugs, Edetate disodium, Enemas, Gallium nitrate, Gentamicin, ibandronate, laxatives, Medroxyprogesterone, Nilotinib, Oxcarbazepine, Pamidronic acid, Pentamidine Isethionate, Pramipexole, Sorafenib, Steroid, Thalidomide, Tolbutamide therapy
Ear Nose Throat	No underlying causes
Endocrine	Absent parathyroid hormone (PTH), Acquired hypoparathyroidism, Adrenocortical hyperplasia, Deficient PTH, Excessive secretion of calcitonin, Familial hypocalcemia, Following thyroidectomy, Hereditary hypoparathyroidism, “Hungry Bone Syndrome” following parathyroidectomy, Hypoparathyroidism, Hypoproteinemia, Medullary carcinoma of the thyroid, Osteitis fibrosa following parathyroidectomy, Osteoporosis, Pseudohypoparathyroidism, Thyroid cancer
Environmental	Decreased ultraviolet/sun (vitamin D deficiency), Defective Vitamin D metabolism, Exposure to hydrofluoric acid
Gastroenterologic	Acute pancreatitis, Cirrhosis, Decreased dietary intake, Eating disorders, Enemas, laxatives, Intestinal malabsorption, Malabsorption, Maldigestion, Pancreatitis, Rickets, Short bowel syndrome, Vitamin-D dependent rickets, type I
Genetic	DiGeorge’s Syndrome, Familial hypocalcemia
Hematologic	Hypoalbuminemia (pseudohypocalcemia), Transfusion of citrated blood, Tumor lysis syndrome
Iatrogenic	No underlying causes
Infectious Disease	Sepsis, Septic shock
Musculoskeletal / Ortho	Enhanced bone formation, Excessive secretion of calcitonin, Neonatal tetany, Osteitis fibrosa following parathyroidectomy, Osteoporosis, Rickets, Vitamin-D dependent rickets, type I
Neurologic	No underlying causes
Nutritional / Metabolic	Absent active vitamin D, Decreased dietary intake, Hyperphosphatemia, Intestinal malabsorption, Intravenous phosphate administration, Magnesium depletion, Rickets, Vitamin D deficiency
Obstetric/Gynecologic	Breast cancer
Oncologic	Breast cancer, Bronchial cancer, Medullary carcinoma of the thyroid, Osteoblastic metastases, Thyroid cancer, Tumor lysis syndrome
Opthalmologic	No underlying causes
Overdose / Toxicity	Magnesium over supplementation, Prolonged use of medications/laxatives containing magnesium
Psychiatric	Eating disorders
Pulmonary	Bronchial cancer, Hyperventilation
Renal / Electrolyte	Acute renal failure, Alkalosis, Chronic renal failure, Hypomagnesemia, Hypoproteinemia, Increased diuresis with physiologic saline solution, Intravenous phosphate administration, Kidney diseases with reduced formation of activated vitamin D, Magnesium depletion, Magnesium over supplementation, Nephrotic syndrome, Renal failure, Rhabdomyolysis, Severe acute hyperphosphatemia
Rheum / Immune / Allergy	DiGeorge’s Syndrome, Osteitis fibrosa following parathyroidectomy, Polyglandular autoimmune syndrome
Sexual	No underlying causes
Trauma	Burns
Urologic	Acute renal failure, Chronic renal failure, Hypoproteinemia, Renal failure
Miscellaneous	Postoperative, Transfusion of citrated blood

Causes in Alphabetical Order

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References

↑ Fong J, Khan A (February 2012). “Hypocalcemia: updates in diagnosis and management for primary care”. Can Fam Physician. 58 (2): 158–62. PMC 3279267. PMID 22439169.
↑ Fong J, Khan A (February 2012). “Hypocalcemia: updates in diagnosis and management for primary care”. Can Fam Physician. 58 (2): 158–62. PMC 3279267. PMID 22439169.

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[pmid22439169-1] Fong J, Khan A (February 2012). “Hypocalcemia: updates in diagnosis and management for primary care”. Can Fam Physician. 58 (2): 158–62. PMC 3279267. PMID 22439169.

[pmid224391692-2] Fong J, Khan A (February 2012). “Hypocalcemia: updates in diagnosis and management for primary care”. Can Fam Physician. 58 (2): 158–62. PMC 3279267. PMID 22439169.

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