A Practical Approach to Hypocalcaemia in Children

Abstract

Hypocalcaemia is one of the commonest disorders of mineral metabolism seen in children and may be a consequence of several different aetiologies. These include a lack of secretion or function of parathyroid hormone, disorders of vitamin D metabolism and abnormal function of the calcium-sensing receptor. A practical approach to the investigation, diagnosis and subsequent management of hypocalcaemic disorders is presented.

Hypoparathyroidism in children and adolescents

“…Severe hypomagnesemia leads to hypocalcemia. [1][2][3][4][5][6][7][8][9] Magnesium deficiency causes both resistance to PTH and decreased PTH secretion, resulting in hypocalcemia. In these patients, serum phosphate level is typically normal or low.…”

“…If urinary calcium excretion is inappropriately normal or high, gain-of-function mutations in the autosomal dominantly inherited gene CASR should be suspected. [2][3][4][5][6][7][8][9] Diagnostic tests for hypocalcemia are shown in Table 1.…”

“…1. [2][3][4][5][6][7][8][9] Genetic syndromes, parathyroid hormone gene mutations, autoimmune polyglandular syndrome, activating mutations of calcium-sensitive receptors (CaSRs), trauma or surgeryrelated parathyroid gland damage, and hypomagnesemia are associated with low parathyroid www.e-apem.org hormone level, whereas nutritional vitamin D and calcium deficiency, vitamin D metabolism disorders, and PHP are associated with high parathyroid hormone level. [2][3][4][5][6][7][8][9] In this review, we discuss the etiology and characteristics of hypoparathyroidism in children.…”

Hypoparathyroidism Should Always Be Checked in Papilledema

“…In the pediatric population, DeGeorge syndrome is one of the possible causes. [2] Such papilledema is almost always bilateral and usually causes minimal or no reduction in visual acuity, sometimes even no blind spot enlargement, at least not early. There have been several documented cases of later papillary atrophy, however.…”