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Iatrogenic hypocalcemic tetany
1Department of Emergency Medicine, Naval Hospital, San Diego, California 92134-5000.
Annals of Emergency Medicine
|August 1, 1990
Summary
Sodium phosphate enemas can cause hypocalcemic tetany, a condition with low calcium levels and muscle spasms. Intravenous and oral calcium effectively treated the patient, resolving symptoms and normalizing electrolytes.
Area of Science:
- Nephrology
- Endocrinology
- Gastroenterology
Background:
- Sodium phosphate enemas are commonly used for bowel preparation.
- Potential risks include electrolyte disturbances, particularly hyperphosphatemia and hypocalcemia.
Observation:
- A patient presented with severe hypocalcemic tetany (serum calcium 5.2 mg/dL) and hyperphosphatemia (serum phosphate 17.5 mg/dL).
- Symptoms included painful tetanic muscle contractions in the extremities.
Findings:
- Intravenous calcium administration led to rapid symptomatic improvement.
- Oral calcium supplementation over two days normalized serum electrolyte levels.
Implications:
- This case highlights a serious adverse effect of sodium phosphate enemas.
- Clinicians should be vigilant for hypocalcemia and tetany in patients receiving these enemas.
- Prompt recognition and treatment with calcium are crucial for patient recovery.