No need to wait for the blood tests: the clinical diagnosis of hypocalcemia
Theocharis Koufakis, Ioannis Gabranis
The Pan African Medical Journal. 2014;17:65. doi:10.11604/pamj.2014.17.65.3881

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No need to wait for the blood tests: the clinical diagnosis of hypocalcemia

Cite this: The Pan African Medical Journal. 2014;17:65. doi:10.11604/pamj.2014.17.65.3881

Received: 17/01/2014 - Accepted: 24/01/2014 - Published: 27/01/2014

Key words: Hypocalcemia, Trousseau sign, ECG, QT interval

© Theocharis Koufakis et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/17/65/full

Corresponding author: Theocharis Koufakis, Department of Internal Medicine, General Hospital of Larissa, Larissa, Greece (thkoyfak@hotmail.com)


No need to wait for the blood tests: the clinical diagnosis of hypocalcemia

 

Theocharis Koufakis1, Ioannis Gabranis1

 

1Department of Internal Medicine, General Hospital of Larissa, Larissa, Greece

 

 

&Corresponding author
Theocharis Koufakis, Department of Internal Medicine, General Hospital of Larissa, Larissa, Greece

 

 

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A 75 years old woman, with a history of cervical cancer, liver and pulmonary metastases, presented to the Emergency Department of our hospital with generalized tonic-clonic seizures. She had an abnormal ECG, mainly characterized by a prolonged QT interval. Trousseau sign was elicited after the sphygmomanometer cuff was inflated to more than the systolic blood pressure on her left arm. In view of these findings, we strongly considered hypocalcemia as the cause of seizures and laboratory investigations confirmed our primary clinical suspicion: she had a corrected blood calcium level of 7 mg/dl (normal values 8.1-10.4 mg/dl). The patient was admitted for further evaluation and her initial treatment included intravenous administration of calcium gluconate. A cranial CT scan was performed, which excluded brain metastases. She was discharged five days later on oral calcium supplements. In conclusion, nowadays, that technology has deeply penetrated the clinical practice, physicians should never forget that in most cases, a thorough physical examination of the patient is enough to establish the diagnosis.



Figure 1: A)Prolonged QT interval on ECG and B) Positive Trousseau sign in a patient with hypocalcemia

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved