PATHOGENIC MECHANISMS OF THE HYPOCALCEMIA OF THE STAPHYLOCOCCAL TOXIC-SHOCK SYNDROME

  • 1 January 1983
    • journal article
    • research article
    • Vol. 101  (4) , 576-585
Abstract
Hypocalcemia is a common finding in toxic-shock syndrome (TSS). This has been causally related to the hypoalbuminemia of TSS. To more clearly define the mechanism responsible for this hypocalcemia, the serum concentrations of total calcium (CaT) Ca2+, immunoreactive calcitonin (iCT), albumin and vitamin D-binding protein (DBP) in 28 women meeting the case-study definition of TSS. Mean CaT was 2.18 .+-. 0.36 mM/l (S.D.), Ca2+ was 0.93 .+-. 0.19 mM/l and iCT was 1941 .+-. 978 pg/ml; all were significantly different (P < 0.01) from the normal values of CaT (2.38 .+-. 0.09), Ca2+ (1.09 .+-. 0.04) and iCT (< 30 to 135). A significant inverse correlation was found between iCT and both CaT and Ca2+, P < 0.001. Serial values were measured in 2 women in whom the iCT values declined each day. Gel filtration of the iCT from 2 patients with the highest values suggested that some polymeric molecular species, rather than authentic CT, accounted for 90% of the circulating iCT value. No abnormalities of DBP levels were found, and no correlation with CaT, Ca2+, or iCT was evident. The hypocalcemia of the TSS represents a reduction in both CaT and Ca2+ concentrations, which may be at least partially accounted for by the elevated iCT concentrations.