Abstract
Symptomatic hypercalcemia is a medical emergency. Knowledge of the alteration in the factors that control normal calcium homeostasis permits selection of a plan of treatment, which includes general supportive measures along with therapeutic agents directed at the specific alteration in calcium homeostasis. The rationale for the selection of various modes of treatment and treatment schedules and the untoward side effects of the therapeutic agents are reviewed.
Acutely developing hypocalcemia often requires emergency treatment. Relief of symptoms can be achieved with intravenous calcium preparations. Knowledge of the underlying cause permits selection of appropriate medications when long-term treatment is required. When vitamin D is needed, measurement of serum calcium and phosphate at regular intervals is essential. Hypoparathyroidism may be temporary after thyroid or parathyroid surgery, and efforts should be made 6 to 12 months after operation to determine whether the abnormality is permanent.
Résumé
L'hypercalcémie symptômatique représente une véritable urgence médicale. La connaissance exacte des modifications des facteurs qui contrô lent l'homéostase calcique permet de choisir un traitement adéquat comportant à la fois des mesures générales et des mesures spécifiques propres à traiter ces anomalies. Le choix des modalités thérapeutiques et du détoulement du traitement ainsi que les effets indésirables des agents thérapeutiques susceptibles d'être employés sont passés en revue par les auteurs.
L'hypocalcémie a évolution aiguë nécessite également un traitement d'urgence. Elle peut être jugulée par l'injection intraveineuse de préparations calciques. La recherche de la cause de l'hypo calcémie permet de choisir la médication adéquate dès lors qu'un traitement à long terme est indispensable. L'emploi au long cours de la vitamine D impose le dosage de la calcémie et de la phosphorémie à intervalles réguliers. L'hypoparathyroïdie après chirurgie thyroïdienne ou parathyroïdienne est souvent provisoire mais il convient au 6ème et au 12ème moist après l'intervention de vérifier que l'hypocalcémie n'est pas permanente.
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Purnell, D.C., van Heerden, J.A. Management of symptomatic hypercalcemia and hypocalcemia. World J. Surg. 6, 702–709 (1982). https://doi.org/10.1007/BF01655362
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DOI: https://doi.org/10.1007/BF01655362