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Immobilization hypercalcemia in spinal cord injury
Archives of Physical Medicine and Rehabilitation
|January 1, 1977
Summary
Young quadriplegic males can develop hypercalcemia (high blood calcium) after injury. This condition requires prompt medical intervention to manage symptoms and prevent complications.
Area of Science:
- Nephrology
- Endocrinology
- Orthopedics
Background:
- High-level quadriplegia can lead to significant physiological changes.
- Understanding metabolic disturbances post-spinal cord injury is crucial for patient management.
Observation:
- Four young male patients (15-19 years) with high-level quadriplegia (C4-C7) developed hypercalcemia within three months of injury.
- Symptoms included nausea, vomiting, polydipsia, polyuria, lethargy, muscle wasting, and cachexia.
- Laboratory findings revealed negative calcium balance, hypercalciuria, and reduced renal function.
Findings:
- Serum calcium levels ranged from 11 to 15.8 mg/100 ml.
- Serum parathormone levels were normal, suggesting a non-parathyroid cause.
- Diffuse demineralization was observed on roentgenograms; one patient developed nephrocalcinosis and soft tissue calcifications.
Implications:
- Hypercalcemia in quadriplegia necessitates careful monitoring and management.
- Treatment strategies involve dietary adjustments, hydration, sodium infusion, and medications like corticosteroids or mithramycin.
- Early intervention can help restore renal function and prevent long-term complications.