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	<title>Comments on: Why there is hypocalcemia in severe pancreatitis?</title>
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		<title>By: Acute Pancreatitis &#124; Absolute Medical</title>
		<link>http://www.emedicinezone.com/discussion/why-there-is-hypocalcemia-in-severe-pancreatitis/comment-page-1#comment-93</link>
		<dc:creator>Acute Pancreatitis &#124; Absolute Medical</dc:creator>
		<pubDate>Fri, 03 Sep 2010 04:34:24 +0000</pubDate>
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		<description><![CDATA[[...] Serum calcium level decrease. [...] ]]></description>
		<content:encoded><![CDATA[<p>[...] Serum calcium level decrease. [...] </p>
<p>Like or Dislike: <img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="up-93" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_up.png" alt="Thumb up" onclick="javascript:ckratingKarma('93', 'add', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_');" title="Thumb up" /> <span id="karma-93-up" style="font-size:12px; color:#009933;">0</span>&nbsp;<img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="down-93" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_down.png" alt="Thumb down" onclick="javascript:ckratingKarma('93', 'subtract', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_')" title="Thumb down" /> <span id="karma-93-down" style="font-size:12px; color:#990033;">1</span></p>]]></content:encoded>
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		<title>By: ukesh</title>
		<link>http://www.emedicinezone.com/discussion/why-there-is-hypocalcemia-in-severe-pancreatitis/comment-page-1#comment-92</link>
		<dc:creator>ukesh</dc:creator>
		<pubDate>Sun, 20 Dec 2009 13:15:06 +0000</pubDate>
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		<description><![CDATA[It is caused primarily by precipitation of calcium soaps in the abdominal cavity,when the pancreas is damaged, free fatty acids are generated by the action of pancreatic lipase. Insoluble calcium salts are present in the pancreas, and the free fatty acids avidly chelate the salts, resulting in calcium deposition in the retroperitoneum.In the other way glucagon-stimulated calcitonin release and decreased PTH secretion may play a role. . In addition, hypoalbuminemia may be a part of the clinical picture, resulting in a reduction in total serum calcium as bivek said. In patients with concomitant alcohol abuse, a poor nutritional intake of calcium and vitamin D, as well as accompanying hypomagnesemia, may predispose those with pancreatitis to hypocalcemia.

Some studies shows that systemic endotoxin exposure and extraskeletal sequestration of calcium appears to play a significant role in the development of hypocalcemia in patients with acute pancreatitis.]]></description>
		<content:encoded><![CDATA[<div style="background-color:#FFFFCC !important"><p>It is caused primarily by precipitation of calcium soaps in the abdominal cavity,when the pancreas is damaged, free fatty acids are generated by the action of pancreatic lipase. Insoluble calcium salts are present in the pancreas, and the free fatty acids avidly chelate the salts, resulting in calcium deposition in the retroperitoneum.In the other way glucagon-stimulated calcitonin release and decreased PTH secretion may play a role. . In addition, hypoalbuminemia may be a part of the clinical picture, resulting in a reduction in total serum calcium as bivek said. In patients with concomitant alcohol abuse, a poor nutritional intake of calcium and vitamin D, as well as accompanying hypomagnesemia, may predispose those with pancreatitis to hypocalcemia.</p>
<p>Some studies shows that systemic endotoxin exposure and extraskeletal sequestration of calcium appears to play a significant role in the development of hypocalcemia in patients with acute pancreatitis.</p>
</div><p>Well-loved. Like or Dislike: <img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="up-92" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_up.png" alt="Thumb up" onclick="javascript:ckratingKarma('92', 'add', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_');" title="Thumb up" /> <span id="karma-92-up" style="font-size:12px; color:#009933;">21</span>&nbsp;<img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="down-92" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_down.png" alt="Thumb down" onclick="javascript:ckratingKarma('92', 'subtract', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_')" title="Thumb down" /> <span id="karma-92-down" style="font-size:12px; color:#990033;">3</span></p>]]></content:encoded>
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		<title>By: admin</title>
		<link>http://www.emedicinezone.com/discussion/why-there-is-hypocalcemia-in-severe-pancreatitis/comment-page-1#comment-91</link>
		<dc:creator>admin</dc:creator>
		<pubDate>Sun, 20 Dec 2009 10:43:42 +0000</pubDate>
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		<description><![CDATA[thank you drbibek 

It makes sense]]></description>
		<content:encoded><![CDATA[<p>thank you drbibek </p>
<p>It makes sense</p>
<p>Like or Dislike: <img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="up-91" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_up.png" alt="Thumb up" onclick="javascript:ckratingKarma('91', 'add', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_');" title="Thumb up" /> <span id="karma-91-up" style="font-size:12px; color:#009933;">1</span>&nbsp;<img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="down-91" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_down.png" alt="Thumb down" onclick="javascript:ckratingKarma('91', 'subtract', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_')" title="Thumb down" /> <span id="karma-91-down" style="font-size:12px; color:#990033;">0</span></p>]]></content:encoded>
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		<title>By: bibek</title>
		<link>http://www.emedicinezone.com/discussion/why-there-is-hypocalcemia-in-severe-pancreatitis/comment-page-1#comment-90</link>
		<dc:creator>bibek</dc:creator>
		<pubDate>Sun, 20 Dec 2009 09:47:29 +0000</pubDate>
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		<description><![CDATA[hypocalcemia may appear as early as the first day of disease because albumin leaks into the the retroperitoneum. Increasing serum albumin proportionally increases serum calcium. Infrequently, loss of ionized  calcium is due to calcium deposition within fat necrosis, hypomagnesemia , or bone refractoriness to an adequate parathyriod response. Indeed parathyiod secretion in response to hypocalcemia in severe acute pancreatitis. IN hypertryglyceridemia, calcium binding to serum free fatty acids also explain hypocalcemia.
      i think i was able clear the cause.. if any plez relpy!!]]></description>
		<content:encoded><![CDATA[<div style="background-color:#FFFFCC !important"><p>hypocalcemia may appear as early as the first day of disease because albumin leaks into the the retroperitoneum. Increasing serum albumin proportionally increases serum calcium. Infrequently, loss of ionized  calcium is due to calcium deposition within fat necrosis, hypomagnesemia , or bone refractoriness to an adequate parathyriod response. Indeed parathyiod secretion in response to hypocalcemia in severe acute pancreatitis. IN hypertryglyceridemia, calcium binding to serum free fatty acids also explain hypocalcemia.<br />
      i think i was able clear the cause.. if any plez relpy!!</p>
</div><p>Well-loved. Like or Dislike: <img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="up-90" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_up.png" alt="Thumb up" onclick="javascript:ckratingKarma('90', 'add', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_');" title="Thumb up" /> <span id="karma-90-up" style="font-size:12px; color:#009933;">12</span>&nbsp;<img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="down-90" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_down.png" alt="Thumb down" onclick="javascript:ckratingKarma('90', 'subtract', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_')" title="Thumb down" /> <span id="karma-90-down" style="font-size:12px; color:#990033;">3</span></p>]]></content:encoded>
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		<title>By: Admin</title>
		<link>http://www.emedicinezone.com/discussion/why-there-is-hypocalcemia-in-severe-pancreatitis/comment-page-1#comment-89</link>
		<dc:creator>Admin</dc:creator>
		<pubDate>Sun, 20 Dec 2009 06:30:04 +0000</pubDate>
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		<description><![CDATA[thanks drhari
ya you are right but there is still unknown pathogenis of hypocalcemia  during acute pancreatic. 
some scientist proposed  some hypothesis ,according to them ,Deficiency of parathyroid hormone due to its destruction by proteolytic enzymes or because of parathyroid gland exhaustion is suggested as the major factor inducing persistent hypocalcaemia in acute pancretitis  and some believed that hypocalcemia is due to   saponification of calcium by fatty acids in areas of fat necrosis as drhari said..
References:
1.www.ncbi.nlm.nih.gov
2.emedicine.medscape.com]]></description>
		<content:encoded><![CDATA[<div style="background-color:#FFFFCC !important"><p>thanks drhari<br />
ya you are right but there is still unknown pathogenis of hypocalcemia  during acute pancreatic.<br />
some scientist proposed  some hypothesis ,according to them ,Deficiency of parathyroid hormone due to its destruction by proteolytic enzymes or because of parathyroid gland exhaustion is suggested as the major factor inducing persistent hypocalcaemia in acute pancretitis  and some believed that hypocalcemia is due to   saponification of calcium by fatty acids in areas of fat necrosis as drhari said..<br />
References:<br />
1.www.ncbi.nlm.nih.gov<br />
2.emedicine.medscape.com</p>
</div><p>Well-loved. Like or Dislike: <img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="up-89" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_up.png" alt="Thumb up" onclick="javascript:ckratingKarma('89', 'add', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_');" title="Thumb up" /> <span id="karma-89-up" style="font-size:12px; color:#009933;">7</span>&nbsp;<img style="padding: 0px; border: none; cursor: pointer;" onmouseover="this.width=this.width*1.3" onmouseout="this.width=this.width/1.2" id="down-89" src="http://www.emedicinezone.com/wp-content/plugins/comment-rating/images/1_14_down.png" alt="Thumb down" onclick="javascript:ckratingKarma('89', 'subtract', 'www.emedicinezone.com/wp-content/plugins/comment-rating/', '1_14_')" title="Thumb down" /> <span id="karma-89-down" style="font-size:12px; color:#990033;">1</span></p>]]></content:encoded>
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