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Hypocalcaemia in severe meningococcal infections.

P B Baines1, A P Thomson, W D Fraser

  • 1Paediatric Intensive Care Unit, Royal Liverpool Children's Hospital, Eaton Rd, Liverpool L12 2AP, UK. p.baines@liverpool.ac.uk

Archives of Disease in Childhood
|November 22, 2000
PubMed
Summary

Hypocalcaemia, or low calcium levels, is common in critically ill children with meningococcal disease. Sicker children experienced lower calcium concentrations, indicating a link to disease severity.

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Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Endocrinology

Background:

  • Meningococcal disease can lead to severe illness in children.
  • Electrolyte imbalances, such as hypocalcaemia, may occur in critical illness.
  • The incidence and clinical correlates of hypocalcaemia in pediatric meningococcal disease are not well-established.

Purpose of the Study:

  • To determine the incidence of hypocalcaemia in critically ill children diagnosed with meningococcal disease.
  • To investigate the relationship between calcium levels and disease severity, fluid resuscitation, and relevant hormones.

Main Methods:

  • Prospective cohort study of 80 consecutive pediatric intensive care admissions for meningococcal disease.
  • Measurement of total and ionised calcium on admission for all patients.

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  • Measurement of parathormone and calcitonin in a subset of patients.

    • Main Results:

    • Hypocalcaemia (low total and ionised calcium) was observed in 70% of the children.
    • Lower calcium concentrations were strongly correlated with increased disease severity.
    • A weak association was found between calcium levels and the volume of colloid fluid administered.

    Conclusions:

    • Hypocalcaemia is a frequent complication in critically ill children with meningococcal disease.
    • Disease severity is a significant factor associated with hypocalcaemia in this population.