Tetany is a condition that is due usually too low blood calcium which is cause by hypocalcemia and is characterized by spasms of the hands and feet, cramps, spasm of the voice box “larynx”, and overactive neurological reflexes. Tetany is commonly considered to result from very low calcium levels in the blood. But, tetany can also result from the reduction in the ionized fraction of plasma calcium without marked hypocalcemia, as is the condition of severe alkalosis that’s when the blood is highly alkaline.
Tetany cause by Hypocalcemia can be acquired or hereditary. Acquired causes are a variety of illnesses eg, hypoparathyroidism, hepatic disease, kidney disease, diet, medication, and surgery. The presentation of tetany or hypocalcemia different widely, from asymptomatic to life-threatening. Tetany is often encountered in patients who are hospitalized. Depending on the cause, poorly treated of tetany conditions can result to essential morbidity or death. Symptomatic patients with classic clinical findings of acute tetany require immediate resuscitation and test. In most cases of tetany are discovered by clinical suspicion and appropriate laboratory testing.
Tetany treatment depends on the cause, the severity, the presence of symptoms, and how fast the tetany developed. In some cases of tetany is clinically mild and require only supportive care and further laboratory test. Oral calcium repletion can be indicated for outpatient care of mild cases. Sometimes, severe tetany can result in seizures, tetany, refractory hypotension, or arrhythmias which require a more aggressive approach, including intravenous infusions of calcium.
Magnesium and calcium in their different forms are the only medications necessary to cure tetany emergencies. The endocrinologist consulting can choose to recommend any of the various vitamin D alternatives depending on laboratory workup result, and oral calcium supplementation for outpatient therapy.
Tetany is found in over half the patients admitted to intensive care units. Studies in critically ill patients have yielded conflicting results, with some suggesting that hypocalcemia is likely a marker of disease severity and that calcium values usually normalize spontaneously with a resolution of the primary disease process. Indeed it has been posited that low levels in critical illness may be protective and attempted correction may be harmful. In contrast, other studies have concluded that both moderate and mild hypocalcemia is associated with increased mortality, whereas mild hypercalcemia is associated with lower mortality. One large retrospective study found that calcium supplementation during the ICU stays improved 28-day survival in critically ill adult patients.
