Impact of intercurrent illness on calcium homeostasis in children with hypoparathyroidism: a case series
| Autor: | D Kendall, M Z Mughal, A Babiker, M Skae, A Chinoy, Raja Padidela |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pediatrics
medicine.medical_specialty Hypercalcaemia intercurrent illness hypocalcaemia Endocrinology Diabetes and Metabolism chemistry.chemical_element 030209 endocrinology & metabolism Calcium lcsh:Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Endocrinology 030225 pediatrics Internal medicine Internal Medicine medicine Hypercalciuria Hypocalcaemia Calcium metabolism lcsh:RC648-665 business.industry Research hypoparathyroidism Alfacalcidol medicine.disease alfacalcidol chemistry Hypoparathyroidism Nephrocalcinosis business |
| Zdroj: | Endocrine Connections, Vol 6, Iss 8, Pp 589-594 (2017) Endocrine Connections |
| ISSN: | 2049-3614 |
| Popis: | Background Hypoparathyroidism is characterised by hypocalcaemia, and standard management is with an active vitamin D analogue and adequate oral calcium intake (dietary and/or supplements). Little is described in the literature about the impact of intercurrent illnesses on calcium homeostasis in children with hypoparathyroidism. Methods We describe three children with hypoparathyroidism in whom intercurrent illnesses led to hypocalcaemia and escalation of treatment with alfacalcidol (1-hydroxycholecalciferol) and calcium supplements. Results Three infants managed with standard treatment for hypoparathyroidism (two with homozygous mutations in GCMB2 gene and one with Sanjad-Sakati syndrome) developed symptomatic hypocalcaemia (two infants developed seizures) following respiratory or gastrointestinal illnesses. Substantial increases in alfacalcidol doses (up to three times their pre-illness doses) and calcium supplementation were required to achieve acceptable serum calcium concentrations. However, following resolution of illness, these children developed an increase in serum calcium and hypercalciuria, necessitating rapid reduction to pre-illness dosages of alfacalcidol and oral calcium supplementation. Conclusion Intercurrent illness may precipitate symptomatic hypocalcaemia in children with hypoparathyroidism, necessitating increase in dosages of alfacalcidol and calcium supplements. Close monitoring is required on resolution of the intercurrent illness, with timely reduction of dosages of active analogues of vitamin D and calcium supplements to prevent hypercalcaemia, hypercalciuria and nephrocalcinosis. |
| Databáze: | OpenAIRE |
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