ECEESPE2025 ePoster Presentations Bone and Mineral Metabolism (142 abstracts)
Two different causes of hypercalcemia
Eva Perle 1 & Iveta Dzivite-Krisane 2
1Children’s clinical university hospital, Riga, Latvia; 2Riga Stradins University, Children’s clinical University Hospital, Riga, Latvia
JOINT1169
Hypercalcemia is not common among children, actual incidence in children is unknown. Although vitamin D intoxication is rare, the health effects can be serious if it is not promptly identified.
| Blood tests | Results | Reference interval |
| Ca (mmol/l) | 3.43 | 2.2-2.7 |
| P (mmol/l) | 1.26 | 0.95-1.75 |
| 25(OH)vitaminD (ng/ml) | 154.2 | 30-50 |
| PTH (pg/ml) | 13.1 | 15-68 |
| Hb (g/dl) | 11.2 | 10.7-13.4 |
| Creatinine (umol/l) | 83 | 21-36 |
| A 2 years old boy – previously healthy, presented with 2 week history of nonspecific symptoms: fatigue, poor apetite, weight gain, constipation. 1st child, 41.g.w., 3.7kg. Weight 9.4kg (-2.5SD), height 86cm (-1SD), HR 150x/min, BR 26x/min, BP 85/60 mmHg. • Additional examination: ECG- short QTc complex, ST segment depression, Echocardiogram- normal, Kidney ultrasound – normal. • Upon detailed questioning, the mother admitted that child receives 1000-2000 units of vitamin D daily, additionally consumes 200ml of adapted formula, as well 200-400ml of sweetened milk with added vitamin D. Total dose of vitamin D – 2600 IU/daily, long term. • Treatment: i/v hydration + loop diuretics for 10 days, + p/o prednisolone (from 7th-10th day). After 3 month with low calcium diet, discontinuation of vitamin D supplementation - Ca 2.38 mmol/l (N), 25(OH)D 87.3 ng/ml (N). | ||
| Blood tests | Results | Reference interval |
| Ca (mmol/l) | 4.43 | 2.2-2.7 |
| P (mmol/l) | 1.46 | 0.95-1.75 |
| 25(OH)vit D (ng/ml) | 525 | 30-50 |
| PTH (pg/ml) | 1.8 | 15-68 |
| Hb (g/dl) | 10.7 | 10.7-13.4 |
| Creatinine umol/l | 43 | 21-36 |
| A 2 years 2 month old boy – previously healthy, complains about ataxia, vomiting (5x), fatigue. 1st child, 41.g.w. 3.8kg. Weight 14.3 kg (+0.5SD), height 90.8cm (0SD) HR 125x/min, BR 24x/min, BP 94/58-143/93mmHg• Additional examination: Fundus oculi – normal CT, MR cerebellum – normal Kidney ultrasound – nephrocalcinosis.ECG, echocardiogram- normal.• Patient receives 400-800 units of vitamin D daily.• Genetic testing: CYP24A1 gene biallelic mutation.• Treatment: i/v hydration + loop diuretics 8 days, hydrocortison 7 days. ACE inhibitor- long-term.The presence of CYP24A1 mutation explains the increased sensitivity to vitamin D in patients with idiopathic infantile hypercalcemia, it is genetic risk factor for development of symptomatic hypercalcemia that may be triggered by vitamin D prophylaxis in otherwise healthy infants. | ||
Conclusions: Nonspecific symptoms like vomiting, constipation, hypertension may be sign of hypercalcemia in children. Symptomatic hypercalcemia is rare in children and requires extensive investigation.
Volume 110
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