What is the best workup for hypocalcemia?
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Unexplained hypocalcemia can usually be diagnosed by a limited number of serum tests when the cause isn't obvious from the history (recent neck surgery or renal failure): • calcium (corrected for serum albumin); • creatinine; • phosphorus; • magnesium; • parathyroid hormone (PTH). The most common causes, categorized according to the results of these tests, are (strength of recommendation: C, expert opinion, case series, and physiologic principles): • high PTH, high phosphorus, and high creatinine: renal failure; • high PTH, low or normal phosphorus, and normal creatinine: vitamin D deficiency or pancreatitis; • low PTH, high phosphorus, and normal creatinine: inadequate parathyroid gland function or hypomagnesemia.
Journal of Family Practice, 57(10) 2008: 677-679.