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Calcium homeostasis disorders are common in emergency departments but often missed. Early suspicion and selective testing are crucial for diagnosing these conditions in adults and children.
Area of Science:
- Internal Medicine
- Emergency Medicine
- Clinical Biochemistry
Background:
- Disorders of calcium homeostasis are frequently encountered but often undiagnosed in emergency settings.
- Causes of hypercalcemia and hypocalcemia are numerous in both adult and pediatric populations.
- A high index of suspicion is necessary for timely diagnosis.
Purpose of the Study:
- To highlight the importance of recognizing and diagnosing calcium homeostasis disorders in the Emergency Department.
- To guide selective laboratory testing for patients at risk.
Main Methods:
- Review of clinical presentations associated with calcium imbalances.
- Identification of patient populations and medical conditions commonly complicated by calcium abnormalities.
- Emphasis on selective laboratory test ordering.
Main Results:
- Calcium homeostasis disorders present with diverse symptoms including altered mental status, seizures, and neuromuscular irritability.
- Conditions such as renal failure, multiple myeloma, metastatic cancer, granulomatous disease, and endocrinopathies are associated with calcium abnormalities.
- Selective testing is recommended for at-risk patients.
Conclusions:
- Prompt diagnosis of calcium homeostasis disorders in the Emergency Department is critical.
- Clinicians should maintain a high index of suspicion for these conditions.
- Targeted laboratory investigations improve diagnostic yield in patients with suspected calcium imbalances.
Abstract:
Disorders of calcium homeostasis are frequent and seldom diagnosed in the Emergency Department. In both the adult and pediatric population, the causes of increased or decreased calcium are many, and the index of suspicion needs to be raised for these disorders. Selective ordering is warranted for patients with altered mental status, seizures, neuromuscular irritability, or in patients with diseases known to have abnormalities of calcium as a complicating factor. These include renal failure, multiple myeloma, metastatic cancer, granulomatous disease, and endocrinopathies.