Management of hypercalcemia and hypocalcemia

Abstract

In the normal human being, the serum calcium levels are kept inside of a narrow range of variation independently of the alimentary state and of physical activity. Therefore, it is possible to maintain the physiological intra and extra-cellular role of this divalent cation which include: a) the stability of membrane, b) participation in the coagulation cascade, c) maintenance of the required mineral ionic product for the mineralization process, d) participation in the excitation and contraction in all forms of skeletal and cardiac muscle, e) hormonal secretion, f) second messenger, mediating the signal induced by the interaction of diverse hormones with their receptors. The regulation of serum calcium levels is maintained by the PTH and 1,25 (OH)2 D which control calcium influx and efflux in bone, intestine and kidney. Fortunately, severe hypocalcemia/hypercalcemia are uncommon occurrences, but when are diagnosed are associated with high index of morbidity and mortality. However, its early recognition and introduction of adequate treatment reduces significantly the involved risks and are fundamental for therapeutic success. Below, we describe a practic guide for evaluation and treatment of hypercalcemia and hipocalcemia in emergency room.