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Calcium and phosphorus metabolic changes in children with hepatic bilharziasis

M Hafez, S W Mohareb, T A Hafez

    The Gazette of the Egyptian Paediatric Association
    |July 1, 1975
    PubMed

    Insights

    Children with hepatic bilharziasis show altered calcium and phosphorus metabolism, with increased urinary excretion and impaired renal handling of these minerals. Ascitic cases exhibited more pronounced metabolic disturbances.

    Area of Science:

    • Pediatric Nephrology
    • Hepatology
    • Mineral Metabolism

    Background:

    • Hepatic bilharziasis (schistosomiasis) is a significant parasitic disease affecting the liver.
    • Mineral metabolism, particularly calcium and phosphorus, can be disrupted in chronic liver diseases.
    • Understanding these metabolic changes is crucial for managing pediatric patients with hepatic bilharziasis.

    Purpose of the Study:

    • To investigate the specific alterations in calcium and phosphorus metabolism in children with hepatic bilharziasis.
    • To compare metabolic profiles between non-ascitic and ascitic pediatric patients with hepatic bilharziasis and healthy controls.

    Main Methods:

    • Cross-sectional study involving 35 children with hepatic bilharziasis (12 with ascites) and 13 healthy controls.
    • Serum and urinary calcium and inorganic phosphate levels were measured.
    • Creatinine clearance, phosphate excretion index (PEI), and tubular reabsorption of phosphate (% TRP) were assessed.
    • Response to phosphate loading and intravenous calcium loading tests were evaluated.

    Main Results:

    • Children with hepatic bilharziasis had normal serum calcium and inorganic phosphate but increased urinary levels.
    • Ascitic fluid calcium and phosphate were 70% and 90.2% of serum levels, respectively.
    • Significantly diminished creatinine clearance, increased PEI, and decreased % TRP were observed, more so in ascitic cases.
    • Bilharzial patients showed a more rapid decrease in serum inorganic phosphate after phosphate load and significant calcium retention after calcium load.

    Conclusions:

    • Hepatic bilharziasis in children is associated with significant disturbances in calcium and phosphorus metabolism, including renal wasting.
    • Ascites exacerbates these metabolic abnormalities.
    • Altered mineral handling suggests potential renal involvement and impaired bone health in these patients.

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