Endocrine Abstracts

Introduction: Hypercalcemia in newborns and infants is often iatrogenic. Clinical signs are correlated with the degree of hypercalcemia and can lead to sever complications through dehydration, neurological disorders, convulsions and cardiac rythm disorders. The objective of our work is to study the clinical, biological, etiological and therapeutic aspects of hypercalcemia in infants.

Material and Methods: Retrospective study on 3 patients hospitalized in our department in which we discovered hypercalcemia defined by a total calcemia > 2.7 mmol/l.

Results: We studied the cases of two girls and one boy. The average age at diagnosis was 3 months (40 days-6 months). The circumstances of discovery were: severe vomiting (1 case), weight loss (2 cases), polyuria with dehydration stage 3 (2 cases). Neurological disorders with hyporeactivity and irritability were objectified in all the patients. The ECG was normal in all cases. The mean blood calcium level was 3.84 mmol/l (3.2–5 mmol/l). Functional renal failure as well as recurrent and deep hypokalemia were found in the 3 cases. Stage II nephrocalcinosis was found in all 3 cases. The etiologies selected were: hypersensitivity to vitamin D in 2 cases (following a single dose of 200 000 IU of vitamin D), and vitamin intoxication in a case where the parents administered by mistake an excessive dose of vitamin D. The treatment consisted in an intravenous hyperhydration with the stop of the intake of vitamin D and calcium, furosemide (3 cases), corticotherapy (1 case), 3 courses of Pamidronate (1 case) and a cure of zoledronic acid (1case). The evolution was favorable in all cases with normalization of calcemia within 4 to 45 days.

Conclusion: Infant hypercalcemia can be evoked in the face of unspecific clinical signs and must be the subject of a rigorous diagnostic process with urgent management.