Frequency and aetiology of hypercalcaemia

Area of Science:

• Pediatric Endocrinology
• Clinical Chemistry
• Neonatal Medicine

Background:

• Hypercalcaemia in children is uncommon but can have severe consequences if untreated.
• Limited data exists on the true frequency and diverse causes of childhood hypercalcaemia.
• Identifying hypercalcaemia is crucial for timely and appropriate clinical management.

Purpose of the Study:

• To determine the incidence of severe hypercalcaemia in children within a routine clinical setting.
• To analyze the underlying aetiologies of sustained severe hypercalcaemia in pediatric patients.

Main Methods:

• Retrospective analysis of laboratory data from 2007-2012 for children aged 0-17 years.
• Severe hypercalcaemia defined as non-adjusted calcium levels ≥2.90 mmol/L.
• Categorization of hypercalcaemia as transient (≤1 day) or sustained (≥2 consecutive days).

Main Results:

• Severe hypercalcaemia occurred in 0.3% of all calcium requests (206 children).
• Sustained hypercalcaemia was observed in 63.3% of cases, with highest frequency in neonates (42%).
• Sepsis was the most common aetiology (24%), particularly in neonates (41%). Genetic and endocrine causes were identified in a smaller proportion.

Conclusions:

• Sustained hypercalcaemia impacts approximately 1 in 500 children in a general hospital.
• The frequency and aetiology of hypercalcaemia vary significantly with age, especially in neonates.
• Thorough investigation is essential for all children with sustained hypercalcaemia to guide management.