Related Experiment Videos
Transient hypocalcemia with elevated serum parathormone in an infant of a hyperparathyroid mother
E A Ismail1, N al-Shammari, H Nadi
1Department of Paediatrics, Farwaniya Hospital, Kuwait.
Insights
An infant experienced a hypocalcemic fit due to maternal parathyroid adenoma. Treatment with calcium and 1-alpha-hydroxyvitamin D resolved symptoms, suggesting brief end-organ refractoriness.
Area of Science:
- Pediatric Endocrinology
- Maternal-Fetal Medicine
- Endocrinology
Background:
- Neonatal hypocalcemia can stem from various causes, including maternal conditions.
- Parathyroid adenoma in mothers can potentially affect infant calcium homeostasis.
- Secondary causes of end-organ refractoriness must be ruled out in hypocalcemic infants.
Observation:
- An 80-day-old infant presented with a hypocalcemic fit.
- The infant's mother had an asymptomatic parathyroid adenoma.
- Elevated intact parathyroid hormone levels were noted in the infant, without hypomagnesemia, renal failure, or rickets.
Findings:
- The infant's condition was attributed to end-organ refractoriness, potentially linked to the maternal condition.
- Treatment with calcium and 1-alpha-hydroxyvitamin D for two weeks resulted in sustained normocalcemia.
- The infant remained asymptomatic and normocalcemic up to two years of age.
Implications:
- This case suggests that brief end-organ refractoriness can cause significant hypocalcemia in infants.
- It highlights the importance of considering maternal parathyroid adenoma as a potential cause of neonatal hypocalcemia.
- Further research may elucidate the mechanisms of transient end-organ refractoriness in this context.
Abstract:
An infant presented at the age of 80 days with a hypocalcemic fit. The mother was found to have asymptomatic parathyroid adenoma. The infant's intact parathyroid hormone was high in the absence of hypomagnesemia, renal failure or overt rickets, which are known causes of secondary end-organ refractoriness. The patient was treated with calcium and 1-alpha-hydroxyvitamin D for only 2 weeks, but has remained asymptomatic and normocalcemic on follow-up to--the age of 2 years. It is believed that this has not been previously described and it is speculated that end-organ refractoriness, though brief, can account for all the symptoms.