Calcium-free hemodialysis for hypercalcemia of malignancy in a newborn

Hypercalcemia associated with malignancy is very rare in the newborn period. Severe hypercalcemia causes neurological and cardiological disturbances and can be life threatening. Calcium-free hemodialysis has not been reported for the treatment of malignancy associated hypercalcemia in neonates. We report a 5-day-old infant with severe hypercalcemia (serum calcium 22 mg/dl) secondary to a solid tumor in the pelvis. Aggressive pharmacological treatment with furosemide, pamidronate, and calcitonin failed to reduce the serum calcium adequately. Implementation of calcium-free hemodialysis resulted in a rapid reduction of the serum calcium from 22.6 mg/dl to 11.6 mg/dl. Hemodialysis was well tolerated with no hemodynamic complications. Continuous veno-venous hemodialysis was used to maintain normocalcemia.