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Hypercalcemia in children with spinal cord injury
Archives of Physical Medicine and Rehabilitation
|October 1, 1978
Summary
Hypercalcemia, or high serum calcium, is common in children with spinal cord injuries, often leading to kidney stones and impaired kidney function. Treatment with saline and furosemide is typically effective.
Area of Science:
- Pediatric Neurology
- Nephrology
- Traumatology
Background:
- Recent spinal cord injury (SCI) in children can lead to significant metabolic disturbances.
- Hypercalcemia is a recognized complication of SCI, but its incidence and clinical manifestations in pediatric populations require further elucidation.
Purpose of the Study:
- To investigate the prevalence and clinical features of hypercalcemia in children with recent spinal cord injury.
- To assess the impact of hypercalcemia on renal function and the incidence of urinary stones in this cohort.
- To evaluate the effectiveness of standard treatment for hypercalcemia in affected children.
Main Methods:
- A retrospective study of 87 children under 16 with recent spinal cord injury over a 7-year period.
- Serum calcium levels were measured in 76 patients; 18 (23.6%) exhibited hypercalcemia (serum calcium > 11 mg%).
- Clinical data, including neurological status (quadriplegia/paraplegia), presenting symptoms, renal function tests, and treatment outcomes, were analyzed.
Main Results:
- Hypercalcemia was observed in 23.6% of pediatric SCI patients, predominantly those with quadriplegia (15/18).
- Five patients presented with symptoms mimicking an acute abdomen, leading to unnecessary exploratory laparotomy in two cases.
- A high incidence of urinary stones (55%) was noted in hypercalcemic patients compared to controls (18%).
- Acute hypercalcemia was associated with decreased renal function, including impaired urine concentration and low creatinine clearance.
- Treatment with saline infusions and furosemide proved effective in managing hypercalcemia.
Conclusions:
- Hypercalcemia is a significant and frequent complication in children with spinal cord injury.
- Prompt recognition and management of hypercalcemia are crucial to prevent complications like renal stones and functional decline.
- Standard treatment protocols involving saline and furosemide are effective for hypercalcemia in this pediatric population.