Abstract
In acutely ill children requiring intensive pediatric care we studied the theses, 1) serum Ca would be low, 2) serum calcitonin (CT) would be elevated, and 3) decrease in serum CT and increase in serum parathyroid hormone (PTH) would result in restoration of serum Ca. In 8 children, ages 3.4±1.1 yrs. (mean ±s.e.), whole blood ionized calcium (iCa), serum Ca, Mg, P, PTH and CT were measured within 24 hrs. of hospitalization, and on days 2 and 3. Serum Ca was 7.9±0.34 on entry (N 8.5-10.5 mg/dl) and increased to 8.3±0.21 and 8.3±0.14 mg/dl, p<0.03, blood iCa was 4.49±0.05 on entry (N 4.7-5.2 mg/dl) and rose to 4.85±0.08 and 4.75±0.16 mg/dl, on days 2 and 3, p<0.015. Serum Ca rose in 7/8 children who improved, and declined in, 1 child who expired. Serum Mg and P did not change. Serum PTH was 83±27 (RIA, N 29.5-85 pmol/L) on entry and 82±23 and 82±28 pmol/L on days 2 and 3, change not significant. Basal serum CT was elevated at 335±126 pg/ml, p<0.05 (RIA, N 54± pg/ml) and remained elevated 255±53 and 238±43 pg/ml on days 2 and 3. Thus, in acutely ill children, 1)serum Ca is low and rise with clinical improvement, 2)serum CT is elevated, 3)serum PTH is normal. We speculate that hypercalcitonemia and transient unresponsiveness to serum PTH may result in hypocalcemia in sick children.
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Sanchez, G., Venkataraman, P., Pryor, R. et al. HYPOCALCEMIA IN ACUTELY ILL CHILDREN: STUDIES IN SERUM Ca, BLOOD IONIZED Ca AND Ca REGULATING TING HORMONES. Pediatr Res 21 (Suppl 4), 206 (1987). https://doi.org/10.1203/00006450-198704010-00241
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DOI: https://doi.org/10.1203/00006450-198704010-00241