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Clinical characteristics of hypercalcemic crises in a tertiary children's hospital
Xuhua Xia1, Jie Cao1, Chunli Long1
1Department of Medical General Ward, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China.
Insights
Hypercalcemic crisis in children is often fatal, with tumors and hereditary diseases as primary causes. Early recognition and intervention are crucial for improving outcomes in pediatric hypercalcemia.
Area of Science:
- Pediatric Endocrinology
- Critical Care Medicine
- Oncology
Background:
- Hypercalcemic crisis is a life-threatening endocrine emergency.
- Few studies have specifically addressed hypercalcemic crises in pediatric populations.
Purpose of the Study:
- To investigate the causes of hypercalcemic crises in children.
- To identify the clinical features associated with hypercalcemic crises in pediatric patients.
Main Methods:
- Retrospective review of electronic medical records for 101 children with hypercalcemia.
- Data collected between January 2016 and December 2021 at a children's hospital.
Main Results:
- Hypercalcemic crises occurred in 28 admissions; 64% of affected patients were infants.
- Tumors (43%) and hereditary diseases (25%) were the leading causes.
- Iatrogenic factors, including blood transfusions, accounted for 11% of cases.
Conclusions:
- Hypercalcemic crisis in children, primarily caused by tumors and hereditary conditions, carries a high mortality risk.
- The condition lacks unique diagnostic features, complicating early recognition.
- Prompt diagnosis and intervention, such as hemodialysis and etiological treatment, can improve prognosis.
Background:
Hypercalcemic crisis is considered a critical and fatal endocrine condition. To date, few reports have focused on hypercalcemic crises in children.
Aim:
To explore the etiology and identify the clinical characteristics related to hypercalcemic crises in children.
Methods:
We enrolled 101 children diagnosed with hypercalcemia between January 1, 2016 and December 31, 2021, admitted to the Children's Hospital of Chongqing Medical University. Electronic medical records were reviewed to determine the causes and clinical characteristics of hypercalcemic crises.
Results:
Hypercalcemic crises occurred in 28 admissions during the 6-year period; 64% of the patients enrolled in the study were infants. The mean corrected total serum calcium was 4.6 ± 0.2 mmol/l. Tumor and hereditary diseases were found in 12 (43%) and 7 (25%) patients, respectively. The ratio of iatrogenic factors was 11% (3/28), and all 3 patients received a blood transfusion. The incidence of poor prognosis in the tumor cases was 50%. Timely intervention including hemodialysis, pamidronate, and etiological treatment was effective in decreasing calcium levels.
Conclusion:
Hypercalcemic crisis is a serious electrolyte disturbance that has the potential for high mortality. The main causes are tumors and hereditary diseases in children. The lack of unique characteristics makes it difficult to recognize by medical caregivers. Early diagnosis and timely intervention could improve the prognosis.
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