Understanding Hypocalcaemia: Symptoms, Causes, and Management

Hypocalcaemia, a condition characterized by low levels of calcium in the blood, can manifest through various symptoms that may significantly affect an individual's quality of life. Common signs include muscle cramps, numbness, and mood swings, which can often be mistaken for other health issues. A notable clinical sign is Trousseau’s sign, where a blood pressure cuff induces muscle spasms in the hand. Another indicative sign is Chvostek’s sign, where tapping on the facial nerve causes twitching of the facial muscles.

The onset of hypocalcaemia can be insidious, making it crucial to recognize its symptoms early. In severe cases, when serum calcium levels drop below 1.5 mmol/L (6.0 mg/dL), patients may experience more severe complications such as convulsions and cardiac arrhythmias, which could be reflected in an ECG showing a long QT interval. Additionally, chronic hypocalcaemia can lead to cataracts, posing another risk factor for affected individuals.

Case histories provide valuable insights into the management of hypocalcaemia. For instance, a 30-year-old woman who developed symptoms two days after a thyroidectomy may be experiencing hypoparathyroidism, where the parathyroid glands are compromised. Such surgical interventions can lead to low calcium levels, warranting immediate attention to alleviate symptoms and restore calcium balance.

In another example, a 26-year-old woman with a family history of calcium replacement therapy presents with hypocalcaemia and recurrent sore throats. The low levels of parathyroid hormone (PTH) alongside her symptoms suggest a genetic condition, possibly linked to her family background. Understanding the underlying cause is crucial for effective management, which may extend beyond merely treating hypocalcaemia to addressing broader endocrine issues.

Diagnosing hypocalcaemia typically involves measuring serum calcium levels, while also assessing phosphate, renal function, and PTH levels for a comprehensive evaluation. Management primarily focuses on restoring calcium levels to prevent acute symptoms and potential complications. While treatment with PTH could be an option for some patients, its high cost and delivery method pose challenges.

In summary, awareness of hypocalcaemia's symptoms and causes is essential for timely diagnosis and management. Through careful evaluation and appropriate treatment strategies, health professionals can help patients navigate the complexities of this condition.