Hypercalcemic Disorders in Children.


eMediNexus    11 July 2018

A recent article published in the Journal of Bone and Mineral Research discussed that hypercalcemic disorders in children may manifest as hypotonia, poor feeding, constipation, vomiting, abdominal pain, lethargy, polyuria, dehydration, failure to thrive, and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms. The causes of hypercalcemia in children can be classified as parathyroid hormone (PTH)-dependent or PTH-independent, and may be congenital or acquired. PTH-independent hypercalcemia is associated with a suppressed PTH and is more common in children. PTH-dependent hypercalcemia is usually caused by parathyroid tumors, which may give rise to primary hyperparathyroidism (PHPT) or tertiary hyperparathyroidism; these usually arises in association with chronic renal failure and in the treatment of hypophosphatemic rickets. PHPT usually occurs as an isolated non-syndromic and nonhereditary endocrinopathy, but may also occur as a hereditary hypercalcemic disorder such as familial hypocalciuric hypercalcemia, neonatal severe primary hyperparathyroidism, and familial isolated primary hyperparathyroidism, and less commonly, as part of inherited complex syndromic disorders such as multiple endocrine neoplasia (MEN). The management of symptomatic hypercalcemia includes interventions such as fluids, antiresorptive medications, and parathyroid surgery.

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