Hypocalcemia can be devastating if unrecognized. Neuromuscular dysfunction occurs in severe cases. A review and an update on the topic may assist general pediatricians. The authors provide a general overview of pathogenesis and management of hypocalcemia in children.
5. Payne RB, Little AJ, Williams RB, Milner JR. Interpretation of serum calcium in patients with abnormal serum proteins. Br Med J1973;4:643-646.
6.
6. Mundy GR, Guise TA. Hormonal control of calcium homeostasis. Clin Chem. 1999;45:1347-1352.
7.
7. Brown EM, Chattopadhyay N, Vassilev PM, Hebert SC. The calcium-sensing receptor permits Ca2+ to function as a versatile extracellular first messenger. Recent Prog Horm Res. 1998;53:257-281.
8.
8. DeLuca F, Baron J. Molecular biology and clinical importance of the Ca2+_ sensing receptor. Curr Opin Pediatr.1998;10:435-440.
9.
9. Perheentupa J. Hypoparathyroidism and mineral homeostasis. In: Lifshitz F, ed. Pediatric Endocrinology. New York: Marcel Dekker Inc; 1996:433-471.
10.
10. Guise TA, Mundy GR. Evaluation of hypocalcemia in children and adults. J Clin Endocrinol Metab.1995;8:1473-1478.
11.
11. Yasuda T, Niimi H. Hypoparathy-roidism and pseudohypoparathy-roidism. Acta Paediatr Jpn. 1997;39: 485-490.
12.
12. Hong R. The DiGeorge anomaly (catch 22, DiGeorge/velocardiofacial syndrome). Semin Hematol. 1998;35: 282-290.
14. Mallette LE. Pseudohypoparathy-roidism. In: Bardin CW, ed. Current Therapy in Endocrinology and Metabolism. St. Louis: CV Mosby; 1997:577-581.
15.
15. Farfel Z, Bourne HR, liri T. The expanding spectrum of G protein diseases. N Engl J Med. 1999;340:1012-1120.
16.
16. Juppner H, Schipani E, Bastepe M, et al. The gene responsible for pseudo-hypoparathyroidism type lb is paternally imprinted and maps in four unrelated kindreds to chromosome 2Oql3.3. Proc Natl Acad Sci USA. 1998;95: 11798-11803.
17.
17. Rude RK. Magnesium metabolism and deticiency. Endocrinol Metab Clin North Am. 1993;22:377-395.
18.
18. Mune T, Yasuda K, Ishii M, et al. Tetany due to hypomagnesemia induced by cisplatin and doxorubicin treatment for synovial sarcoma. Intern Med. 1993;32:434-437.
19.
19. Finberg L. Human choice, vegetable deficiencies, and vegetarian rickets. Am J Dis Child. 1979;133:129-129.
20.
20. Bergstrom WI-I. When you see rickets, consider calcium deficiency. J Pediatr1998;133:722-724.
22. Pfitzner MA, Thacher TD, Pettifor JM, et al. Absence of vitamin D deficiency in young Nigerian children. J Pediatr1998;133:740-744.
23.
23. Pugliese MT, Blumberg DL, Hludzinki J, Kay S.Nutritional rickets in suburbia. j Am Coll Nutr1998;17:637-641.
24.
24. Pettifor JM, Ross P, Wang J, et al. Rickets in children of rural origin in South Africa: is low dietary calcium a factor?J Pediatr1978;92:320-324.
25.
25. Davidovits M, Levy Y, Avramovitz T, Eisenstein B. Calcium-deficiency rickets in a four-year-old boy with milk allergy.J Pediatr1993;122:249-251.
26.
26. Karrar ZA. Vitamin D deficiency rickets in developing countries. Ann Trop Paediatr1998;18:S89-S92.
27.
27. Moncrieff M, Fadahunsi TO. Congenital rickets due to maternal vitamin D deficiency. Arch Dis Child. 1974;49:810-811.
28.
28. Rigo J, De Cutis M, Pieltain C, et al. Bone mineral metabolism in the micropremie. Clin Perinatol. 2000;27:147-171.
29.
29. Ryan S. Nutritional aspects of meta-bolic bone disease in the newborn. Arch Dis Child. 1996;74:F145-F148.
30.
30. Miller WL, Portale AA. Genetic causes of rickets. Curr Opin Pediatr. 1999;11:333-339.
31.
31. Hahn TJ, Shires RA, Halstead LR. Serum 25-hydroxycalciferol levels and bone mass in children on chronic anticonvulsant therapy. N Engl J Med. 1975;292:550-554.
32.
32. Tjellesen L. Metabolism and action of vitamin D in epileptic patients on anticonvulsive treatment and healthy adults. Dan Med Bull. 1994;41:139-150.
33.
33. Kruse K. On the pathogenesis of anti-convulsant-drug-induced alterations of calcium metabolism. Eur J Pediatr1982;138:202-205.
34.
34. Alderman CP, Hill CL. Abnormal bone mineral metabolism after long-term anticonvulsant treatment. Ann Pharmacother1994;28:47-48.
35.
35. Tjellesen L, Nilas L, Christiansen C. Does carbamazepine cause disturbances in calcium metabolism in epileptic patients?Acta Neurol Scand. 1983;68:13-19.
36.
36. Baer MT, Kozlowski BW, Blyler EM, et al. Vitamin D, calcium, and bone status in children with developmental delay in relation to anticonvulsant use and ambulatory status. Am J Clin Nutr1997;65:1042-1051.
37.
37. Kafali G, Erselcan T, Tanzer F. Effect of antiepileptic drugs on bone mineral density in children between ages 6 and 12 years. Clin Pediatr. 1999;38:93-98.
38.
38. Takkeshita N, Seino Y, Ishida H, et al. Increased circulating levels of y-car-boxyglutamic acid-containing protein and decreased bone mass in children on anticonvulsant therapy. Calcif Tissue Int. 1989;44:80-88.
39.
39. Yamano Y, Sakane S, Takamatsu J, Oh-sawa N. Estrogen supplementation for bone dematuration in young epileptic man treated with anticonvulsant therapy; a case report. Endocrinol J. 1999;46:306-307.
40.
40. Jones G, Strugnell SA, DeLuca HF. Current understanding of the molecular actions of vitamin D. Physiol Rev. 1998;78:1193-1231.
42. Mimouni FB, Root AW. Disorders of calcium metabolism in the newborn. In: Sperling MA, ed. Pediatric Endocrinology. Philadelphia: WB Saunders Co; 1996:95-115.
43.
43. Sakhaee K, Gonzalez GB. Update on renal osteodystrophy: pathogenesis and clinical management. Am J Med Sci. 1999;317:251-260.
44.
44. Slatopolsky E, Finch J, Denda M, et al. Phosphorus restriction prevents parathyroid gland growth; high phosphorus directly stimulates PTH secretion in vitro. J Clin Invest. 1996;97:2534-2540.
45.
45. Levine BS, Carpenter TO. Evaluation and treatment of heritable forms of rickets. The Endocrinologist. 1999;9:358-365.
46.
46. Root AW, Diamond FB, Mimouni FB. Parathyroid and vitamin D-related disorders in children and adolescents. In: Sperling MA, ed. Pediatric Endocrinology. Philadelphia: WB Saunders Co; 1996:477-507.
47.
47. Castells S, Greig F, Fusi MA, et al. Severely deficient binding of 1,25-dihy-droxyvitamin D to its receptors in a patient responsive to high doses of this hormone. J Clin Endocrinol Metab.1986;63:252-256.
48.
48. Hochberg Z, Weisman YCalcitriol-resistant rickets due to vitamin D receptor defects. Trends Endocrinol Metab. 1995;6:216-220.
49.
49. Shah BR, Laude TA. Nutritional vitamin D deficiency rickets. In: Shah BR, Laude TA, eds. Atlas of Pediatric Clinical Diagnosis. Philadelphia: WB Saunders Co; 2000:360-365.