Metabolic Abnormalities in Crohn's

The Correct Answer is C


Explanation:

The causes of hypocalcemia, an abnormal reduction of serum calcium, can quickly be determined by examining the serum phosphorus, creatinine, and calcium. In hypoparathyroidism, there is reduced mobilization of calcium from bone, reduced renal reabsorption of calcium (along with decreased phosphaturia), and reduced formation of 1,25-hydroxyvitamin D, resulting in reduced intestinal absorption of calcium. Consequently, the hypocalcemia is accompanied by hyperphosphatemia. Hypoparathyroidism can be congenital or acquired; the latter is accounted for by transient or permanent disorders.

Hypomagnesemia causes deficient secretion of PTH and consequent functional hypoparathyroidism.

In vitamin D deficiency, decreased intestinal absorption of calcium leads to secondary hyperparathyroidism, which increases renal tubular loss of phosphate. Vitamin D deficiency can result from inadequate dietary intake, lack of sun exposure, and malabsorption. Renal failure impairs hydroxylation of 25-hydroxyvitamin D, which results in the malabsorption of calcium.

The body compensates by increased secretion of PTH, leading to increased mobilization of calcium from bone. Renal failure is characterized by an abnormal serum creatinine, whereas renal dysfunction is not the critical pathogenetic feature of the other forms of hypocalcemia.

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