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Response of protracted neonatal hypocalcaemia to 1alpha,25-dihydroxyvitamin D3
Insights
This study shows that intravenous 1alpha,25-dihydroxyvitamin D3 (1alpha,25-(OH)2D3) effectively treats protracted neonatal hypocalcaemia, rapidly normalizing calcium levels in infants. It offers a safe and dependable therapeutic option for this condition.
Area of Science:
- Pediatrics
- Endocrinology
- Neonatology
Background:
- Protracted neonatal hypocalcaemia, including tetany of the newborn, is characterized by low plasma-calcium and elevated inorganic phosphate levels.
- Some infants remain hypocalcaemic for over two weeks despite conventional treatments like low phosphate formulas and calcium supplementation.
Purpose of the Study:
- To evaluate the safety and efficacy of intravenous 1alpha,25-dihydroxyvitamin D3 (1alpha,25-(OH)2D3) in treating protracted neonatal hypocalcaemia.
Main Methods:
- Six infants with hypocalcaemia were treated with 1alpha,25-(OH)2D3 intravenously at a dose of 0.05 mug/kg/day for 5-12 days.
- Plasma-calcium levels were monitored throughout the treatment period.
Main Results:
- Intravenous 1alpha,25-(OH)2D3 administration led to a rapid increase in plasma-calcium levels within 24 hours.
- Normal plasma-calcium levels were achieved within 8 days of treatment initiation.
- While four infants maintained normal calcium levels after discontinuation, two required long-term therapy.
Conclusions:
- Intravenous 1alpha,25-dihydroxyvitamin D3 is a safe and dependable treatment for protracted neonatal hypocalcaemia.
- The treatment demonstrates rapid efficacy in normalizing calcium levels in affected infants.
- Long-term management may be necessary for some infants following initial treatment.
Abstract:
Six infants with protracted hypocalcaemia (5 classed as tetany of the newborn) had a mean plasma-calcium of less than 6-4 mg/dl and raised plasma-inorganic-phosphate. Four had been hypocalcaemic for longer than 2 weeks despite treatment with low phosphate formulae and extra calcium. All the infants were treated with 1alpha,25-dihydroxyvitamin D3 (1alpha,25-(OH)2D3), usually in a dose of 0-05 mug/kg body-weight/day, administered intravenously for 5--12 days. The plasma-calcium levels began to rise within 24 h after starting 1alpha,25-(OH)2D3 treatment, increased above 7-5 mg/dl within 3 days, and reached the normal range within 8 days. Four of the infants remained normocalcaemic when 1alpha,25-(OH)2D3 was discontinued, but two infants became hypocalcaemic again and required long-term treatment. 1alpha,25-(OH)2D3 has been found safe and dependable as treatment for protracted neonatal hypocalcaemia.