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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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Related Experiment Video

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Is severe hypercalcemia immediately life-threatening?

Camille Guimard1, Eric Batard1, Frédéric Lavainne2

  • 1Departments of Emergency Medicine.

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine
|March 25, 2017
PubMed
Summary

Severe hypercalcemia (calcium > 4 mmol/l) is not associated with immediate life-threatening cardiac or neurological events in emergency departments. This study found no such complications in patients with severe hypercalcemia.

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Area of Science:

  • Emergency Medicine
  • Clinical Biochemistry
  • Cardiology

Background:

  • Severe hypercalcemia is often perceived as a medical emergency.
  • Limited evidence supports the immediate life-threatening risks of severe hypercalcemia.

Purpose of the Study:

  • To evaluate the association between severe hypercalcemia (calcium > 4 mmol/l) and life-threatening cardiac arrhythmias or neurological complications.
  • To assess risks in patients admitted to the Emergency Department (ED).

Main Methods:

  • Retrospective observational study (2008-2012) at a tertiary hospital ED.
  • Included adult patients with calcium > 4 mmol/l.
  • Primary outcome: life-threatening cardiac/neurological complications during ED stay.

Main Results:

  • 31 patients (0.025%) had severe hypercalcemia (median calcium 4.3 mmol/l).
  • No life-threatening cardiac events occurred during ED stay.
  • One patient had a coma of multifactorial origin; no correlation between calcemia and QTc intervals.

Conclusions:

  • Severe hypercalcemia (> 4 mmol/l) was not associated with immediately life-threatening cardiac arrhythmias or neurological complications in this large tertiary ED cohort.
  • Findings challenge the emergency classification of severe hypercalcemia based on these acute risks.