The Daily Consumption of Cola Can Determine Hypocalcemia: A Case Report of Postsurgical Hypoparathyroidism-Related Hypocalcemia Refractory to Supplemental Therapy with High Doses of Oral Calcium.
The consumption of soft drinks is a crucial factor in determining persistent hypocalcemia. The aim of the study is to evaluate the biochemical mechanisms inducing hypocalcemia in a female patient with usual high consumption of cola drink and persistent hypocalcemia, who failed to respond to high doses of calcium and calcitriol supplementation. At baseline and after pentagastrin injection, gastric secretion (Gs) and duodenal secretion (Ds) samples were collected and calcium and total phosphorus (Ptot) concentrations were evaluated. At the same time, blood calcium, Ptot, sodium, potassium, chloride, magnesium concentrations, and vitamin D were sampled. After intake of cola (1 L) over 180 min, Gs and Ds and blood were collected and characterized in order to analyze the amount of calcium and Ptotor sodium, potassium, magnesium, and chloride ions, respectively. A strong pH decrease was observed after cola intake with an increase in phosphorus concentration. Consequently, a decrease in calcium concentration in Gs and Ds was observed. A decrease in calcium concentration was also observed in blood. In conclusion, we confirm that in patients with postsurgical hypoparathyroidism, the intake of large amounts of cola containing high amounts of phosphoric acid reduces calcium absorption efficiency despite the high doses of calcium therapy.
Biomedical Department of Internal and Specialist Medicine (DIBIMIS), Section of Endocrine-Metabolic Diseases, University of Palermo , Palermo , Italy.
Valentina
V
Guarnotta
Department of Science and Technologies Biological Chemical and Pharmaceutical (STEBICEF), Section of Chemistry, University of Palermo , Palermo , Italy.
Serena
S
Riela
Department of Science and Technologies Biological Chemical and Pharmaceutical (STEBICEF), Section of Chemistry, University of Palermo , Palermo , Italy.
Marina
M
Massaro
Department of General, Emergency and Transplant Surgery, Unit of General and Emergency Surgery, P. Giaccone Policlinico , Palermo , Italy.
Sebastiano
S
Bonventre
Department of General, Emergency and Transplant Surgery, Unit of General and Emergency Surgery, P. Giaccone Policlinico , Palermo , Italy.
Angela
A
Inviati
Biomedical Department of Internal and Specialist Medicine (DIBIMIS), Section of Endocrine-Metabolic Diseases, University of Palermo , Palermo , Italy.
Alessandro
A
Ciresi
Biomedical Department of Internal and Specialist Medicine (DIBIMIS), Section of Endocrine-Metabolic Diseases, University of Palermo , Palermo , Italy.
Giuseppe
G
Pizzolanti
Department of Clinical and Experimental Medicine, Endocrinology, University of Messina , Messina , Italy.
Salvatore
S
Benvenga
Biomedical Department of Internal and Specialist Medicine (DIBIMIS), Section of Endocrine-Metabolic Diseases, University of Palermo , Palermo , Italy.
Carla
C
Giordano
calcium absorption; cola; hyperphosphatemia; hypocalcemia; hypoparathyroidism