Persistent hypocalcemia: an interesting maze!!

Authors

  • Jinela Desouza Department of Pediatrics, Dr D.Y. Patil Hospital and Research Institute, Kolhapur, Maharashtra, India
  • Anees U. P. Department of Pediatrics, Dr D.Y. Patil Hospital and Research Institute, Kolhapur, Maharashtra, India
  • Mohan Patil Department of Pediatrics, Dr D.Y. Patil Hospital and Research Institute, Kolhapur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20222775

Keywords:

Hypocalcemia, Hypoparathyroidism, Convulsions

Abstract

A 2 months old child was brought with c/o arching of back and fisting present since day 15 of life, which was increased during feeding and h/o not gaining weight since birth. They were evaluated at a local doctor where the child was started on calcium syrup and the child is taking the medications for 1 month. Despite the treatment, the child was still having the similar complaints. Now the child has been brought to the hospital with multiple episodes of breath-holding spells, convulsions, and not feeding well, with significant weight loss and lethargic. After clinical evaluation, various laboratory investigations were carried out which led us to even better diagnosis. The blood calcium levels were found to be persistently low. We did multiple investigations, keeping the physiology of calcium and vitamin D metabolism in mind and arrived at a conclusion.

Metrics

Metrics Loading ...

References

Al-Azem H, Khan AA. Hypoparathyroidism. Best Pract Res Clin Endocrinol Metab. 2012;26:517-22.

Witteveen JE, van Thiel S, Romijn JA, Hamdy NA. Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature. Eur J Endocrinol. 2013;168:R45-53.

Shaw N. A practical approach to hypocalcaemia in children. In Allgrove J, Shaw NJ (eds): Calcium and Bone Disorders in Children and Adolescents. Endocr Dev. 2009;16:73-92.

Lee S, Mannstadt M, Guo J. A homozygous [Cys25]PTH(1-84) mutation that impairs PTH/PTHrP receptor activation defines a novel form of hypoparathyroidism. J Bone Min Res. 2015;30:1803-13.

Tuchman S. Disorders of mineral metabolism in the newborn. Curr Pediatr Rev. 2014;10:133-41.

Miri Aliabad G, Khajeh A, Fayyazi A, Safdari L. Clinical, Epidemiological and Laboratory Characteristics of Patients with Febrile Convulsion. J Comprehensive Pediatrics. 2013;4(3):134-7.

Sh R. Clinical Aspects of Patients with Febrile Convulsion: A survey in Mashhad. J Patient Safety & Quality Improvement. 2014;2(1):44-7.

Al-Eissa YA. Febrile seizures: rate and risk factors of recurrence. J Child Neurol. 1995;10(4):315-9.

Ahmed I, Atiq M, Iqbal J, Khurshid M, Whittaker P. Vitamin D deficiency rickets in breast-fed infants presenting with hypocalcaemic seizures. Acta Paediatr. 1995;84(8):941-2.

Nakamura Y, Matsumoto T, Tamakoshi A. Prevalence of idiopathic hypoparathyroidism and pseudohypoparathyroidism in Japan. J Epidemiol. 2000;10(1):29-33.

Sanchez J, Perera E, Jan de Beur S. Madelung‒like deformity in pseudohypoparathyroidism type 1b. J Clin Endocrinol Metab. 2011;96(9):E1507-11.

Balavoine AS, Ladsous M, Velayoudom FL. Hypothyroidism in patients with pseudohypoparathyroidism type Ia: clinical evidence of resistance to TSH and TRH. Eur J Endocrinol. 2008;159(4):431-7.

Kim CJ. Vitamin D dependent rickets type I. Korean J Pediatr. 2011;54(2):51-4.

Downloads

Published

2022-10-27

How to Cite

Desouza, J., U. P., A., & Patil, M. (2022). Persistent hypocalcemia: an interesting maze!!. International Journal of Contemporary Pediatrics, 9(11), 1112–1114. https://doi.org/10.18203/2349-3291.ijcp20222775

Issue

Section

Case Reports