25th July 2023

A 72 year old man with a background of alcohol excess was admitted for acute pancreatitis.

A 72 year old man with a background of alcohol excess was admitted for acute pancreatitis. He was subsequently transferred to ITU due to pancreatic necrosis, worsening hypocalcemia and multiorgan failure. He then commenced Total Parenteral Nutrition (TPN). His hypocalcemia prior to initiation of TPN was corrected intravenously. Blood tests the next day show worsening hypocalcemia.

What is the most likely explanation for the persistent hypocalcemia?

Select the SINGLE most appropriate option from the list below. Select ONE option only.