Hypocalcemia - Differential Diagnosis Algorithm - Low and High PTH
LOW PTH - Hypoparathyroid
- Congenital (Pediatric)
• Ca-S-R
• DiGeorge
- Acquired
• Post-operative neck
• Radiation
• Infiltrative disease
• Autoimmune polyendocrinopathy
• Hypomagnesemia
HIGH PTH
- 25-OH D very low
• Malabsorption
• Short gut
• Gastric bypass
• Liver disease
• Increased Vit-D degradation (eg. anti-convulsants)
- 25-OH D not very low
• Chronic Renal Failure
• Severe hyperphosphatemia (eg. Tumor lysis syndrome, rhabdomyolysis, oral phosphate abuse/laxatives)
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