1/8. Generalized seizure in a 30-year-old man with presumed intracranial hemorrhage: a case report.A 30-year-old man presented to the emergency department of another institution with recurrent episodes of generalized tonic-clonic seizures. He was found to be hypocalcemic and was treated with an intravenous infusion of calcium followed by Dilantin. A computed tomography scan of the head was obtained, and the patient was transferred to our institution for neurosurgical evaluation and possible intervention of what was thought to be bilateral intracranial hemorrhages. After further evaluation at our institution, the diagnoses of hypoparathyroidism associated with hypocalcemic seizures and basal ganglia calcifications were established on both clinical and biochemical grounds. This case report discusses the clinical presentation, pathogenesis, diagnostic work-up, and management of hypoparathyroidism and associated seizures, highlighting the possible diagnostic and therapeutic pitfalls that are most pertinent to the emergency physician.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/8. Spurious hypocalcemia after gadodiamide administration.Severe hypocalcemia may require prompt intervention to avoid life-threatening consequences. We report a case in which a 78-year-old man had a critically low serum calcium level measured with use of standard colorimetric assay after gadodiamide administration during magnetic resonance angiography. Reanalysis of the same serum specimen using absorption spectroscopy revealed normal calcium values, confirming the diagnosis of spurious hypocalcemia. The increasing use of gadolinium chelates during magnetic resonance imaging and anglography will lead to a marked increase in reports of critically low serum calcium values. Increasing physicians' awareness of gadodiamide-induced spurious hypocalcemia may prevent unnecessary and potentially inappropriate therapeutic interventions.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/8. Hypocalcaemia following therapy of thyrotoxicosis in an infant.A 2-mo-old infant born to a mother with Graves' disease and having symptoms of thyrotoxicosis was started on antithyroid drugs. life-threatening hypocalcaemia requiring high-dose calcium infusions developed 1 mo after starting therapy. serum alkaline phosphatase and paratharmone levels were elevated. This communication may serve to alert treating physicians about this rare complication in infants with thyrotoxicosis after initiation of antithyroid therapy. Conclusion: Severe hypocalcaemia may follow initiation of antithyroid therapy in infants with thyrotoxicosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/8. Severe hyperphosphatemia and hypocalcemic tetany after oral laxative administration in a 3-month-old infant.A 3-month-old infant presented to the pediatric emergency department with respiratory distress and tetany after ingestion of a phosphate-containing oral laxative. The initial phosphorus level was 38.3 mg/dL. With aggressive fluid resuscitation and intravenous calcium administration, the infant completely recovered. Although the risks of phosphate-containing enemas are well described, life-threatening hyperphosphatemia can also result from administration of phosphate-containing oral laxatives. Aggressive fluid hydration is the mainstay of treatment. Intravenous calcium administration may be necessary to avoid hemodynamic collapse despite the theoretical possibility of metastatic calcifications. physicians should be alerted to the possibility of phosphate toxicity and hypocalcemic tetany in young children when treated with over-the-counter laxatives. caregivers should be advised not to administer over-the-counter laxatives to infants without physician supervision.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/8. An infant fatality associated with inspiratory and expiratory wheezing: another wheeze that wasn't asthma.The physician who encounters an infant with respiratory distress associated with inspiratory stridor and expiratory wheezing should maintain an expanded differential diagnosis. hypocalcemia should be included in the differential diagnosis for biphasic wheezing. Failure to consider this entity may lead to adverse patient outcome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/8. Hypocalcemic seizures in neonates.A case of a 2-week-old infant who presented to the emergency department (ED) with rapid eye blinking and jerking in the absence of physical abnormalities is presented. hypocalcemia and hypomagnesemia were detected. This case represents the common presentation, therapy, and outcome of neonatal hypocalcemia. It is of particular interest to ED physicians because most of the time the etiology of neonatal seizures can be diagnosed in the ED and appropriate therapy can be immediately instituted.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/8. hypocalcemia and stridor: an unusual presentation of vitamin d-deficient rickets.The differential diagnosis of stridor in the pediatric population is broad and should include hypocalcemia with resultant laryngospasm. We present the case of a breast-fed infant who presented to the pediatric emergency department with profound stridor during the winter months because of hypocalcemia of undiagnosed rickets. The patient responded to intravenous calcium chloride with rapid resolution of symptoms. Emergency physicians should consider obtaining ionized calcium levels in pediatric patients with stridor, especially when standard therapies for more common causes of stridor are ineffective.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/8. Hypocalcemic heart failure: a reversible form of heart muscle disease.This paper reports the case of a 53-year-old woman with hypocalcemia-induced reversible cardiomyopathy. Laboratory tests showed hypocalcemia caused by idiopathic hypoparathyroidism. Her left ventricular dysfunction persisted for a long period even after normalization of the serum calcium level. Observations suggest that physicians should be aware that hypocalcemia can be a reversible cause of cardiomyopathy and congestive heart failure.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |