Hypocalcaemia
Hypocalcaemia in clinical conditions is rarely caused by inadequate calcium ingestion. This may occur after operations on the thyroid gland,if too much parathyroid tissue is removed, or due to impaired alimentary absorption. It may also occur in patients with the malabsorption syndrome.
When plasma ionic calcium is reduced, nerve and muscle become more readily excitable.Sensation of tingling and numbness may be present and on the motor side twitching of muscles,known as tetany,which may be followed by spasm,involuntary muscle contraction.The face,hands and feet are mainly affected ; characteristically the wrist and metacarpo phalangeal joints are flexed and the interphalangeal joints extended.The larynx may be affected and this causes a coarse stridor,harsh sound.Paresthesia of lips,tongue,fingers and feet may occur in hypocalcaemia.
Hypercalcaemia
This occurs in adultsย as a result of hyperparathyroidism or excessive doses of Vitamin D.Hypercalcaemia can occur in infants as a result of high intakes of Vitamin D.It is best corrected by reducing the Vitamin D content of the diet,rather than by reducing the dietary calcium intake.It has also been reported in patients with peptic ulcer and impaired renal function treated with a milk diet and large doses of alkali.It may also occur in patients with cancer of the lung and at other sites due to "inappropriate" secretion of a parathyroid hormone - like substance by tumour cells.
In hypercalcaemia, gastrointestinal symptoms include anorexia,nausea,vomiting,constipation, abdominal pain.Renal stones and muscle weakness can also occur.Hypercalcaemia can be reduced by treatment with calcitonin.
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Nutrition Science by B. Srilakshmi
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