What are the typical symptoms of hepatic osteodystrophy?

What are the typical symptoms of hepatic osteodystrophy?

1. Decreased blood calcium, Ca2 is relatively antagonistic to Mg2 and K, which manifests as increased nerve excitation, and slight stimulation can cause muscle spasms. The prodromal symptoms of hand and foot convulsions include limb fatigue, fatigue, insensitivity, muscle erection, etc. Early manifestations include numbness, burning, and insensitivity to touch in the limbs, lips or tongue, followed by stiffness of the upper and lower limb muscles and temporary muscle spasms. Systemic spasms may occur in severe cases. The main manifestations are tense spasms of the distal muscles of the limbs, namely the forearm, fingers, and lower limb flexor muscles, which are usually symmetrical. Generally, there is no disturbance of consciousness.

2. The most common digestive symptoms are loss of appetite, nausea and vomiting, accompanied by weight loss and constipation, which may lead to dehydration and dysphagia. Significant hypercalcemia is manifested by abdominal distension, intestinal colic, and increased secretion of gastric acid and pepsin in hypercalcemia, which may be accompanied by ulcer disease.

3. When hypercalcemia is not severe, the deposition of calcium salts in the kidneys can cause irreversible renal tissue damage, which can be the cause of persistent hypertension and renal failure. In progressive hypercalcemia, the first manifestation is decreased renal concentrating ability and polyuria, followed by dehydration and anuria.

4. Mild symptoms include memory loss, fatigue, weakness, insomnia, depression, and apathy. Serum calcium exceeding 4mmol/L causes acute mental disorders, insomnia, excitement, delusion, drowsiness, rigidity, disorientation, and eventually coma.

5. In hypercalcemia, neuromuscular excitability is reduced, systemic muscle tension is reduced, tendon reflexes are reduced or absent, and mild muscle atrophy may occur. In severe hypercalcemia, the joints of the limbs may be overstretched due to reduced muscle tension.