Presentation
We report an atypical case of complete DiGeorge (DG) anomaly that presented initially exclusively as severe combined immunodeficiency (SCID). [ncbi.nlm.nih.gov]
Entire Body System
- Asymptomatic
Subsequently, asymptomatic maternal hyperparathyroidism and vitamin D deficiency were also detected. The infant was asymptomatic with no pertinent past medical or family history. [jsnhd.or.jp]
They emphasize the need for a definition of NHC in terms of serum ionized rather than total calcium concentrations, the rationale for treating symptomatic NHC, as well as the need for further research in infants with asymptomatic NHC. [ncbi.nlm.nih.gov]
Early onset: IV 10% calcium gluconate Late onset: Oral calcitriol or calcium Early-onset hypocalcemia ordinarily resolves in a few days, and asymptomatic neonates with serum calcium levels > 7 mg/dL (1.75 mmol/L) or ionized calcium > 3.5 mg/dL (0.88 mmol [msdmanuals.com]
- Sepsis
Background: Neonatal hypocalcemia is defined as S-Ca Case presentation and clinical management: We present three boys (two with gestational age 39 weeks, one 36 weeks; none of them with either asfyxia or sepsis) with mild hypotonia, where S-Ca in the [bone-abstracts.org]
High risk infants: - Preterm babies - Infants of diabetic mother - Birth asphyxia - Sepsis - Respiratory distress - Infants with functional or transient hypoparathyroidism - Small for gestation age infants × Contributor Information and Disclosures Ira [pediatriconcall.com]
Severe burns and sepsis can also reduce PTH. Fluctuations in ionized calcium is responsible for symptoms. Neonates are particularly at risk for hypocalcemia .[ Thornton, 2013 ] Fetal skeleton has a high demand for calcium and phosphorus. [pedemmorsels.com]
The common causes of late-onset hypocalcemia include cow's milk intake, maternal Vitamin D deficiency, congenital hypoparathyroidism (DiGeorge syndrome), maternal hyperparathyroidism, hypomagnesemia, renal tubular acidosis, hyperphosphatemia, and sepsis [jcnonweb.com]
Patients were excluded if there was any history of anticonvulsant use, subsequent diagnosis of DiGeorge Syndrome by FISH, or confirmed sepsis. Infants were also excluded if the mother had diabetes mellitus or a known disorder of calcium metabolism. [ijpeonline.biomedcentral.com]
- Epilepsy
[…] brain detected using magnetic resonance imaging or computed tomography, including atrophy and calcification, or a history of epilepsy or schizophrenia. [nature.com]
[…] grand mal, petit mal, focal) Other uncontrolled movements Chronic hypocalcemia may produce the following dermatologic manifestations: Coarse hair Brittle nails Psoriasis Dry skin Chronic pruritus Poor dentition Cataracts Associated Co-morbidities [3] Epilepsy [physio-pedia.com]
There was no history of maternal diabetes, pregnancy-induced hypertension, epilepsy, and drug intake. On clinical examination, the child was alert but had jitteriness. Heart rate was between 80 and 100/min with normal peripheral perfusion. [jcnonweb.com]
- Pediatric Disease
Succinct, targeted coverage of normal childhood growth and development, as well as the diagnosis, management, and prevention of common pediatric diseases and disorders, make this an ideal medical reference book for students, pediatric residents, nurse [books.google.de]
Cardiovascular
- Tachycardia
Signs include hypotonia, tachycardia, tachypnea, apnea, poor feeding, jitteriness, tetany, and seizures. Similar symptoms may occur with hypoglycemia and opioid withdrawal. [msdmanuals.com]
Last Update: 2012-04-10 Usage Frequency: 2 Quality: Reference: Demo English nervousness tremor vertigo tachycardia bradycardia hypertension migraine syncope myalgia edema hypocalcemia hypoglycemia hypokalemia apnea hiccup hypoventilation dyspnea lung [mymemory.translated.net]
Musculoskeletal
- Neonatal Tetany
Abstract Primary hyperparathyroidism in the mother during pregnancy is known to result in a high rate of fetal complications; spontaneous abortions, still births, and neonatal tetany occur in excessive incidence. [ncbi.nlm.nih.gov]
Abstract Findings in a case of neonatal tetany in a child whose mother had elevated blood parathyroid hormone levels because of a parathyroid adenoma are given. The child was found to have hypocalcemia, hypomagnesemia, and hyperphosphatemia. [annals.org]
CASES of neonatal tetany not due to rickets were reported in the early 1900's. It was only during the last 30 to 40 years, however, that the relation between tetany in the newborn infant and hypocalcemia has been elucidated. [nejm.org]
Neonatal tetany without calcium or magnesium deficiency Or: 2015/16 ICD-10-CM P71.4 Transitory neonatal hypoparathyroidism Or: 2015/16 ICD-10-CM P71.8 Other transitory neonatal disorders of calcium and magnesium metabolism ICD-9-CM Volume 2 Index entries [icd9data.com]
The latter has two main peaks of occurrence: during the first 48 hours following delivery (early hypocalcemia), or after the second part of the initial week of life (late hypocalcemia or classical neonatal tetany) (1). [link.springer.com]
- Muscle Twitch
The following are the most common symptoms of hypocalcemia: irritability muscle twitches jitteriness tremors poor feeding lethargy seizures [childrenshospital.org]
Symptoms may include: Irritability Muscle twitches Jitteriness Tremors Poor feeding Lethargy Seizures The symptoms of hypocalcemia may resemble other conditions or medical problems. Always consult your baby's doctor for a diagnosis. [stanfordchildrens.org]
- Osteoporosis
Complications from calcium deficiency disease include eye damage, an abnormal heartbeat, and osteoporosis. [healthline.com]
Neurologic
- Seizure
Neonatal seizures were significantly associated with neonatal hypocalcemia in the entire sample (P < 0.0001), regardless of intellectual level. [ncbi.nlm.nih.gov]
[…] by neonatal seizures. [nature.com]
ABSTRACT Four children; all between 10-40 days of age, were admitted with multiple episodes of multifocal seizure. [degruyter.com]
Hypocalcemia can slow down your heart, which can impair oxygen delivery to the brain and provoke a seizure. Seizure control Infants with hypocalcemia and seizures need prompt attention in order to control the convulsions. [livestrong.com]
- Convulsions
Also when methods of clinical inclusion/EEG are used, evaluating only the epileptic phenomena, convulsive crises with minimal clinical signs are observed. [ncbi.nlm.nih.gov]
Usually, babies have normal blood calcium levels, but low calcium, or hypocalcemia, can cause significant health consequences, including convulsions. [livestrong.com]
Since hypomagnesemia and hypocalcemia in the neonatal period may be associated with electroencephalographic abnormalities, tetany, convulsions, and cardiac disturbances, and since traditional treatment of neonatal hypocalcemia (i.e. calcium salts) is [grantome.com]
[…] hyperparathyroidism (3) maternal vitamin D deficiency (4) prematurity (5) intrauterine growth retardation (6) prolonged delivery, anoxia and/or asphyxia (7) familial hypoparathyroidism Clinical manifestations: (1) onset during the first 72 hours after birth (2) convulsions [meducator3.net]
Neonates with jitteriness represented seven cases (14%) and those with convulsions represented five cases (10%) of hypocalcemic neonates [Table 5]. [mmj.eg.net]
- Neonatal Seizures
Neonatal seizures were significantly associated with neonatal hypocalcemia in the entire sample (P < 0.0001), regardless of intellectual level. [ncbi.nlm.nih.gov]
[…] by neonatal seizures. [nature.com]
Neonatal Seizures should not be approached similarly to other seizures. [pedemmorsels.com]
Neonatal seizures and familial hypomagnesemia with secondary hypocalcemia. Pediatr Neurol. 2005; 33 (3): 202-5[ DOI ][ PubMed ] [emedicalj.com]
- Confusion
Although only occasionally reported previously, MIO remains essentially unrecognized by clinicians as a cause of neonatal hypocalcemia, which often results in diagnostic confusion and delay. [ncbi.nlm.nih.gov]
Tetany It is important not to confuse seizures in a neonate with tetany. Tetany is a painful, sustained spasm of the hands and feet that can mimic seizure activity. Decreased calcium levels can also cause tetany. [livestrong.com]
Hypocalcemia Other names Hypocalcemia Calcium within the periodic table Specialty Endocrinology Symptoms Numbness, muscle spasms, seizures, confusion [1] [2] Complications Cardiac arrest. [1] [2] Causes Hypoparathyroidism, vitamin D deficiency, kidney [en.wikipedia.org]
Severe symptoms of hypocalcemia include: confusion or memory loss muscle spasms numbness and tingling in the hands, feet, and face depression hallucinations muscle cramps weak and brittle nails easy fracturing of the bones Calcium deficiencies can affect [healthline.com]
Workup
The consulting endocrinologist may choose to prescribe any of the various vitamin D supplements depending on laboratory workup findings, and oral calcium supplementation for outpatient therapy. [physio-pedia.com]
(See Prognosis, Clinical, Workup, and Treatment.) The definition of hypocalcemia is based on both gestational and postnatal age in neonates and is different for children. [emedicine.medscape.com]
Etiological workup was suggestive of hypocalcemia. The child was further worked up for the etiology of early-onset hypocalcemia. The child was full term with no features of growth retardation. [jcnonweb.com]
Treatment
Make informed clinical choices for each patient, from diagnosis and treatment selection through post-treatment strategies and management of complications, with new evidence-based criteria throughout. [books.google.de]
Treatment is IV or oral calcium supplementation. [msdmanuals.com]
Prognosis
Mutation of T-cell immune regulator 1 (TCRG1) gene is the most common genetic defect leading to osteopetrosis, with poor prognosis. [ncbi.nlm.nih.gov]
Prognosis The prognosis is variable and depends on the severity of the disease. The infant mortality rate is relatively low (~4%); in adults mortality is higher than that of the rest of the adult population. [orpha.net]
Treatment of LNH: Treatment of LNH Prognosis and outcome Most cases of early neonatal hypocalcemia resolve within 48-72 hours without any clinically significant sequelae. [authorstream.com]
Prognosis Most cases of early-onset neonatal hypocalcemia resolve within 48-72 hours without any clinically significant sequelae. [emedicine.medscape.com]
Etiology
Etiological considerations include decreased calcium (Ca) supply, increased endogenous phosphate load, hypomagnesemia, alkali therapy, functional hypoparathyroidism, defects in vitamin D metabolism, and possibly calcitonin excess. [ncbi.nlm.nih.gov]
DiGeorge syndrome, velocardiofacial syndrome, cardiofacial syndrome) but are now known to be etiologically identical and are referred to as 22q11.2 DS. [orpha.net]
After a full physical examination and biochemical studies which ruled out other etiologies, a diagnosis of neonatal hypoparathyroidism was reached. [elsevier.es]
Epidemiology
Summary Epidemiology The worldwide incidence is estimated at 1/2,000-1/4,000 live births. Clinical description 22q11.2 DS shows a variable clinical phenotype that can range from mild to severe. [orpha.net]
Early neonatal predictors of neonatal hypocalcemia in infants of diabetic mothers: an epidemiologic study. Am J Perinatol. 1990; 7 (3): 203-6[ DOI ][ PubMed ] 11. Alam M, Raza SJ, Sherali AR, Akhtar AS. [emedicalj.com]
Epidemiology Occurrence in the United States The incidence of neonatal hypocalcemia varies in different studies. Data on the incidence and prevalence rates in the neonatal period are limited. [emedicine.medscape.com]
Pathophysiology
To understand the pathophysiology of neonatal hypocalcemia that accompanies this disorder, transplacental calcium dynamics were studied in female sheep during the last trimester of pregnancy and in their fetal lambs after hysterotomy. [ncbi.nlm.nih.gov]
It has been postulated that the pathophysiologic mechanism of the hypocalcemia in this syndrome is transient hypoparathyroidism. [annals.org]
IDMs demonstrate a delay in this postnatal parathyroid hormone response, the pathophysiology of which is not well established. [jemds.com]
These bone density losses are significantly reversed within twelve months of weaning. [2] Pathophysiology Hypocalcemia manifests as central nervous system (CNS) irritability and poor muscular contractility. [emedicine.medscape.com]
Prevention
CONCLUSIONS: Although lack of Vitamin D is preventable and curable, it is an important health problem for newborns in Turkey. [ncbi.nlm.nih.gov]
Conclusion: Phototherapy-induced hypocalcemia can be prevented by covering the head during phototherapy. [dovepress.com]
Phototherapy plays a significant role in the treatment and prevention of hyperbilirubinemia in neonates. [mmj.eg.net]
Succinct, targeted coverage of normal childhood growth and development, as well as the diagnosis, management, and prevention of common pediatric diseases and disorders, make this an ideal medical reference book for students, pediatric residents, nurse [books.google.de]