A 58-year-old man on ICU has severe acute pancreatitis (Ranson score 6, APACHE II 22). On day 3, his serum calcium drops to 1.6 mmol/L (corrected). Wh...

Question

A 58-year-old man on ICU has severe acute pancreatitis (Ranson score 6, APACHE II 22). On day 3, his serum calcium drops to 1.6 mmol/L (corrected). What is the pathophysiological mechanism of hypocalcaemia in acute pancreatitis?

Accepted Answer

Saponification - calcium binds to free fatty acids released by pancreatic lipase-mediated fat necrosis in the retroperitoneum

Answer

Excessive urinary calcium loss from loop diuretic use

Answer

Primary hypoparathyroidism from autoimmune destruction

Answer

Vitamin D deficiency from malabsorption

Answer

Citrate toxicity from blood transfusion

uk-fficm MCQ (SBA): Acute Pancreatitis

A 58-year-old man on ICU has severe acute pancreatitis (Ranson score 6, APACHE II 22). On day 3, his serum calcium drops to 1.6 mmol/L (corrected). What is the pathophysiological mechanism of hypocalcaemia in acute pancreatitis?