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  1. Seen at serum levels < 8 mg/dL
  2. Causes: hypoalbuminemia, hypomagnesemia, hyperphosphatemia, medication effect, parathyroid deficiency or resistance, vitamin D deficiency or resistance, pancreatitis, renal failure, osteoblastic malignancy, infiltrative disorders (sarcoidosis, TB, or hemochromatosis)
  3. Symptoms: perioral numbness and tingling, hyperactive tendon reflexes, muscle and abdominal cramps, tetany, seizures, prolongation of QT interval, positive Chvostek’s sign (contraction of the facial muscles in response to a tap over the facial nerve in front of the ear) and Trousseau's sign ( inflation of the blood pressure cuff above the systolic pressure casues ulnar/median ischemia with carpal spasm), seizures, calcifications of the basal ganglia/cerebellum/cerebrum, increased phosphate levels
  4. Treatment
    1. mild forms: oral repletion
    2. severe forms: IV calcium gluconate or calcium chloride
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