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Vitamin D deficiency and hypocalcemia in an infant with newly diagnosed AML

Cathleen Cook1, Valeria Bernardo, John Shelso

  • 1Departments of *Pediatric Hematology and Oncology §Oncology, St Jude Children's Research Hospital, Memphis, TN †Department of Pharmacy Practice, St Louis College of Pharmacy, St Louis, MO ‡Department of Pediatric Endocrinology, Sanford Children's Specialty Clinic, Sioux Falls, SD.

Journal of Pediatric Hematology/Oncology
|April 27, 2013
PubMed

Insights

A 4-month-old infant with acute myeloid leukemia developed hypocalcemia after leukoreduction therapy. Addressing underlying vitamin D deficiency with cholecalciferol normalized calcium levels, highlighting its importance in pediatric leukemia care.

Area of Science:

  • Pediatric Hematology Oncology
  • Biochemistry
  • Clinical Medicine

Background:

  • Acute myeloid leukemia (AML) in infants presents unique challenges.
  • Hyperleukocytosis is a common complication requiring prompt management.
  • Leukoreduction therapy can lead to metabolic disturbances.

Observation:

  • A 4-month-old male with AML and hyperleukocytosis underwent chemical leukoreduction.
  • The patient developed symptomatic hypocalcemia following treatment.
  • Serum calcium levels failed to normalize until vitamin D deficiency was identified and treated.

Findings:

  • Low-dose cytarabine effectively reduced white blood cell count.
  • Symptomatic hypocalcemia was directly linked to an underlying vitamin D deficiency.
  • A single dose of cholecalciferol corrected the hypocalcemia within 48 hours.

Implications:

  • Vitamin D deficiency should be considered in the differential diagnosis of prolonged hypocalcemia in infants with leukemia.
  • Prompt management of vitamin D deficiency is crucial for normalizing calcium levels in pediatric cancer patients.
  • This case underscores the importance of comprehensive metabolic evaluation and management in infants undergoing leukemia treatment.

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