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Hypocalcemia in an 11 Year Old Child: A Difficult Case to Treat

P Purohit1, D Khera2, K Singh2

  • 11Department of Biochemistry, AIIMS Jodhpur, Room No C-106, Basni Phase II, Jodhpur, 342005 India.

Indian Journal of Clinical Biochemistry : IJCB
|October 16, 2018
PubMed

Insights

Severe hypocalcemia in a child with chronic kidney disease caused seizures and hypovitaminosis D. Prolonged intravenous calcium gluconate therapy was required to normalize ionized calcium levels.

Area of Science:

  • Pediatric Nephrology
  • Clinical Medicine
  • Biochemistry

Background:

  • Hypocalcemia is a common laboratory and clinical abnormality in pediatric patients.
  • It can present with neurological symptoms like seizures and irritability, and cardiac dysfunction.
  • Chronic kidney disease (CKD) is a significant risk factor for metabolic disturbances, including hypocalcemia.

Purpose of the Study:

  • To report a unique case of severe hypocalcemia in a pediatric patient with CKD.
  • To highlight the clinical manifestations and management of this condition.
  • To emphasize the importance of monitoring calcium levels in children with CKD.

Main Methods:

  • Case report of an eleven-year-old male child.
  • Clinical presentation, laboratory investigations (including calcium, vitamin D levels, EEG, ECG), and treatment were analyzed.
  • Management involved prolonged intravenous calcium gluconate therapy.

Main Results:

  • The patient presented with severe hypocalcemia, tonic-clonic seizures, and hypovitaminosis D.
  • Electroencephalogram (EEG) and electrocardiography (ECG) were normal, ruling out significant neurological or cardiac electrical abnormalities.
  • Intravenous calcium gluconate therapy was effective in correcting ionized calcium levels.

Conclusions:

  • Severe hypocalcemia can be a presenting manifestation of CKD in children, leading to significant neurological complications.
  • Prompt and adequate calcium replacement is crucial for managing hypocalcemic seizures.
  • This case underscores the importance of comprehensive metabolic evaluation in pediatric CKD patients.

Keywords:
Intravenous calcium gluconate therapyPediatric hypocalcemiaSeizuresVitamin D

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