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Life-threatening hypercalcemia complicated by pancreatitis in a child with acute lymphoblastic leukemia

Elpis Mantadakis1, Nicole Anagnostatou, Penelope Smyrnaki

  • 1Department of Pediatric Hematology/Oncology, University Hospital of Heraklion, Heraklion, Crete, Greece.

Journal of Pediatric Hematology/Oncology
|May 14, 2005
PubMed

Insights

Severe hypercalcemia in a child with precursor-B acute lymphoblastic leukemia (ALL) required intensive care. Prompt treatment of ALL and supportive care resolved the life-threatening complication.

Area of Science:

  • Pediatric Oncology
  • Pediatric Hematology
  • Pediatric Critical Care Medicine

Background:

  • Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
  • Metabolic complications, such as hypercalcemia, can occur in children with ALL.
  • Hypercalcemia is an uncommon but potentially life-threatening complication in pediatric ALL.

Observation:

  • A 9-year-old girl with precursor-B ALL presented with severe hypercalcemia and dehydration.
  • She had received recent oral vitamin D and calcium supplementation.
  • Hospitalization in a pediatric intensive care unit (PICU) was required for management.

Findings:

  • The patient developed pancreatitis, disseminated intravascular coagulation, pleural effusion, and seizures.
  • Hypercalcemia was likely multifactorial, related to ALL and possibly supplementation.
  • Hypercalcemia resolved with chemotherapy, supportive care, and calcitonin.

Implications:

  • This case highlights the importance of recognizing and managing hypercalcemia in pediatric ALL.
  • Prompt diagnosis and multidisciplinary care are crucial for managing severe metabolic complications.
  • Referral to tertiary-care centers with PICU and subspecialty support is recommended for children with ALL.

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