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
- Poor Feeding
Signs include hypotonia, tachycardia, tachypnea, apnea, poor feeding, jitteriness, tetany, and seizures. Similar symptoms may occur with hypoglycemia and opioid withdrawal. [msdmanuals.com]
The following are the most common symptoms of hypocalcemia: irritability muscle twitches jitteriness tremors poor feeding lethargy seizures [childrenshospital.org]
- 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]
Respiratoric
- Tachypnea
Signs include hypotonia, tachycardia, tachypnea, apnea, poor feeding, jitteriness, tetany, and seizures. Similar symptoms may occur with hypoglycemia and opioid withdrawal. [msdmanuals.com]
The signs and symptoms of neonatal hypocalcemia and hypomagnesemia are similar to those of hypoglycemia and include jitteriness, sweating, tachypnea, irritability, and seizures. [jemds.com]
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]
Psychiatrical
- Suggestibility
Our observations suggest that taking large doses of calcium carbonate during pregnancy may be a potential cause of neonatal hypocalcemia. [ncbi.nlm.nih.gov]
- Withdrawn
Serum calcium levels normally decline to nadir values (9 mg/dL) at 24 hours of age as the newborn is abruptly withdrawn from the transplacental supply of maternal calcium, and then increase to steady state values as secretion of PTH increases and that [clinicaladvisor.com]
Neurologic
- 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]
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]
Serum
- Hypoglycemia
Similar symptoms may occur with hypoglycemia and opioid withdrawal. [msdmanuals.com]
P70.4 Other neonatal hypoglycemia P70.8 Other transitory disorders of carbohydrate metabolism of newborn P70.9 Transitory disorder of carbohydrate metabolism of newborn, unspecified P71 Transitory neonatal disorders of calcium and magnesium metabolism [icd10data.com]
- Calcium Decreased
For every 0.1 increase in pH, ionized calcium decreases by about 0.05 mmol/L. [en.wikipedia.org]
Acidotic pH decreases Ca2+ binding to proteins. Calcium homeostasis is complex! [ Kelly, 2013 ] Parathyroid Hormone (PTH) directly increased serum calcium levels. [pedemmorsels.com]
QT, RR, ST Intervals
- Prolonged QT Interval
(1) onset during the first 72 hours after birth (2) convulsions (3) ECG changes (prolonged QT interval, conduction abnormalities) (4) tetany (5) transient course Laboratory testing: (1) low serum calcium. [meducator3.net]
The causes of prolonged QT interval in neonates are hypocalcemia, hypomagnesaemia, hypocalcemia, hypothermia, postcardiac arrest, congenital long QT syndrome, and drugs. Etiological workup was suggestive of hypocalcemia. [jcnonweb.com]
The presence of a prolonged QT interval by electrocardiography is a physiologic marker of hypocalcemia. [clinicaladvisor.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]