Hypocalcemia - 低カルシウム血症 -

1) Hypoalbuminemia (Hypoproteinemia)

2) Decreased PTH activity
2-1) Primary hypoparathyroidism (damaged parathyroid gland)
2-2) Pseudo-hypothyroidism (decreased PTH receptor responsiveness)

3) Inadequate Ca mobilization from bone or absorption in intestine
・ Hypovitaminosis D (CKD, PLE)
・ Rickets
・Exocrine pancreatic insufficiency
・Nutritional hypocalcemia (VERY RARE)

4) Excess urinary excretion of Ca
・Ethylene glycol toxicosis
・Intravenous HCO3- infusion
・Furosemide

5) Ca binding with diffuse leads anions 
・Anticoagulants : EDTA,citrate, oxalate
・Tetracycline administration

6) Ca deposition during fracture healing 

7) Other or unknown mechanism
・Acute pancreatitis 
・urinary tract obstruction
・AKI
・Phosphate enemas
・Acute tumor lysis syndrome
・Sepsis / SIRS (Systemic inflammatory Response Syndrome)

✔︎ Sever hypocalcemia (iCa < 1.0)
・Hypoparathyroidism
・PLE

✔︎ Mild to Moderate (iCa 1.0-1.2)
・Acute Pancreatitis
・AKI
・CKD
・SIRS / Sepsis