Hypocalcemic symptoms during plateletpheresis using the COBE Spectra: a comparison of oral combination of 600mg calcium+300mg magnesium+100IU vitamin D3 vs. a 1000mg calcium in symptomatic donors.
BACKGROUND
The aim of this study was to find an effective treatment for hypocalcemic symptoms during plateletpheresis and to evaluate if a combination of calcium, magnesium and vitamin D3 is more effective in comparison to routine calcium supplementation.


METHODS
A study group consisting of 10 donors, having a history of previous hypocalcemic symptoms during plateletpheresis, donated platelets twice in a one-month period. During the first donation combination tablets (600mg Ca+300mg Mg+100IU vitamin D3) were used to treat hypocalcemic symptoms while routine treatment calcium carbonate tablets (1000mg Ca) were used during the second donation. If symptoms persisted after 10min the same dose was repeated. A control group, with no supplementation, consisting of five donors, with no history of hypocalcemic symptoms, were included. Donor subjective symptoms were graded and recorded on four occasions: at the start of plateletpheresis, when symptoms appeared, 10min after the first tablet and at the end of donation. Samples for analysis of ionized calcium (iCa), magnesium and potassium were also taken at the same occasions.


RESULTS
All donors from the study group experienced minor or medium hypocalcemic symptoms and needed a second dose of supplementation. Calcium carbonate tablets completely relieved the hypocalcemic symptoms in six donors, it had no effect on three donors and one donor experienced aggravated symptoms. The combination tablets completely relieved the symptoms in three donors, one donor experienced a partial relief and six donors had no relief of symptoms. There were no significant differences in iCa, potassium and magnesium levels were noted in the study group irrespective of which tablets were used for treatment of hypocalcemic symptoms. After plateletpheresis the median iCa levels declined by 30% and potassium levels declined by 3-11% in all donors while the magnesium levels were not significantly affected. There was no correlation between the presence of symptoms and the changed levels of iCa or magnesium.


CONCLUSIONS
Addition of magnesium and vitamin D3 to calcium seems to have no beneficial effect in the treatment of hypocalcemic symptoms in plateletpheresis donors.
Palfi
Miodrag
M
Department of Transfusion Medicine and Clinical Immunology, University Hospital, 581 85 Linköping, Sweden. miodrag.palfi@lio.se
Martinsson
Lotta
L
Sundström
Kristina
K
D002118:Calcium / Q000008:administration & dosage* / Q000097:blood; D016022:Case-Control Studies; D002762:Cholecalciferol / Q000008:administration & dosage* / Q000097:blood; D004359:Drug Therapy, Combination; D006801:Humans; D006996:Hypocalcemia / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D008274:Magnesium / Q000008:administration & dosage* / Q000097:blood; D010983:Plateletpheresis / Q000009:adverse effects*; D011188:Potassium / Q000097:blood; D011292:Premedication / Q000379:methods; D016896:Treatment Outcome
D002762:Cholecalciferol; D008274:Magnesium; D011188:Potassium; D002118:Calcium