[Diffusible blood calcium in children with advanced protein energy malnutrition]

A previous study had shown that in children with third degree protein-energy malnutrition, ultrafilterable or diffusible serum calcium concentrations remain normal, while the protein-bound fraction is low in those with hypoalbuminemia, accounting for over-all hypocalcemia. In order to retest those findings, a new series consisting of 20 small marasmic infants and 16 children with kwashiorkor was studied, using a membrane ultrafiltration procedure. Fifteen eutrophic children served as controls. At time of their admission into hospital, both groups of patients showed hypocalcemia, more so the cases of kwashiorkor. Diffusible calcium was normal, while the protein-bound moiety was significantly decreased in children with kwashiorkor. Upon recovery, protein-bound as well as total calcium concentrations returned to normal values.