Original article | Volume 17, Article 65, 27 Jan 2014 | 10.11604/pamj.2014.17.65.3881

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

Theocharis Koufakis, Ioannis Gabranis

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

Received: 17 Jan 2014 - Accepted: 24 Jan 2014 - Published: 27 Jan 2014

Domain: Clinical medicine

Keywords: Hypocalcemia, Trousseau sign, ECG, QT interval

©Theocharis Koufakis et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Theocharis Koufakis et al. No need to wait for the blood tests: the clinical diagnosis of hypocalcemia. Pan African Medical Journal. 2014;17:65. [doi: 10.11604/pamj.2014.17.65.3881]

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

Home | Volume 17 | Article number 65

Original article

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

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Original article

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

Original article

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

Original article

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

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Key words

Hypocalcemia

Trousseau sign

ECG

QT interval

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