Clinical manifestations-hypocalcemia
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Neuromuscular irritability: perioral paresthesias, cramps, ⊕ Trousseau’s (inflation of BP cuff ≥3 min → carpal spasm), ⊕ Chvostek’s (tapping facial nerve → contraction of facial muscles), laryngospasm; irritability, depression, psychosis, seizures, ↑ QT
- 神經肌肉過敏:口周感覺異常、痙攣(手、臉、喉、腦)
- ⊕ Trousseau’s(BP 袖帶充氣≥3 分鐘 → 腕部痙攣)
- ⊕ Chvostek’s(敲擊面神經 → 面部肌肉收縮)啾咪Sign
- “Chvostek sign” is pronounced: vos-tek
- 喉痙攣;
- 易怒、抑鬱、精神病、癲癇發作,↑ QT
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Rickets and/or osteomalacia: chronic ↓ vit D → ↓ Ca, ↓ PO4 → ↓ bone/cartilage mineralization, growth failure, bone pain, muscle weakness
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Renal osteodystrophy: osteomalacia [↓ mineralization of bone due to ↓ Ca and 1,25-(OH)2D] & osteitis fibrosa cystica (due to ↑ PTH), adynamic bone disease or mixed uremic osteodystrophy; dx by bone biopsy
- 腎性骨營養不良:骨軟化症 [↓ Ca 和 1,25-(OH)2D 導致的骨礦化] 和纖維囊性骨炎(↑ PTH 導致)、無動力性骨病或混合性尿毒症性骨營養不良; dx 通過骨Bx