Hypocalcemic Convulsion in Formula Feeding Young Infants

Kim, Mi-Jung; Ko, Cheol-Woo; Koo, Ja-Hoon

J Korean Soc Pediatr Nephrol > Volume 2(1); 1998 > Article

J Korean Soc Pediatr Nephrol 1998;2(1): 14-19.

영아에서 경련을 동반한 저칼슘혈증에 관한 연구

김미정, 고철우, 구자훈

¹경북의대 소아과학교실
²경북의대 소아과학교실
³경북의대 소아과학교실

Hypocalcemic Convulsion in Formula Feeding Young Infants

Mi-Jung Kim, Cheol-Woo Ko, Ja-Hoon Koo

¹Department of Pediatrics, Kyungpook National University, School of Medicine
²Department of Pediatrics, Kyungpook National University, School of Medicine
³Department of Pediatrics, Kyungpook National University, School of Medicine

ABSTRACT

Purpose : Hypocalcemia is one of the major causes of convulsion in infants. The causes of hypocalcemia are hypoparathyroidism, deficiency and metabolic abnormalities of vitamin D, or increased uptake of inorganic phosphorous, etc. We analyzed the causes, symptoms and signs, treatment, and clinical courses of hypocalcemia as, recently, there were many clinical experiences of hypocalcemic infants under age of 6 months in the department of pediatrics, Kyungpook University Hospital. Objects and
Methods : The authors observed 11 infants with hypocalcemia who had been admitted to the department of pediatrics, Kyungpook University Hospital, during the period of February 1992 to April 1997. Various clinical and laboratory data concerning causes, clinical courses and treatment of hypocalcemia were analyzed retrospectively
Results : (1) The sex incidence revealed male predominance with male to female ratio 4.5 : 1. The mean age at onset of symptoms was $2.2{pm}1.1$ months old. (2) The causes of hypocalcemia were vitamin D deficiency in 8 cases and excessive inorganic phosphate intake in 3 cases. (3) All eleven patients manifestated convulsion which was generalized tonic-clonic in 9, and focal clonic in 2 cases. (4) Serum calcium concentrarion increased from $6.3{pm}0.9$ mg/dL to $9.9{pm}1.7$ mg/dL after therapy of $1,25(OH)_{2}D_{3}$ with or without calcium(P=0.0008), and serum ALP concentration decreased from $1,418{pm}864$ U/L to $772{pm}503$ U/L (P=0.0112). Serum iPTH levels were high in all 11 patients initially. All showed decreased $25(OH)D_3$ levels initially. (5) All patients were treated successfully with $1,25(OH)_{2}D_{3}$ and/or calcium supplement.
Conclusions : Vitamin D deficiency should be considered as one of the causes of hypocalcemia even in formula(known as vitamin fortified) feeding infants. Fortunately, they were successfully treated with $1,25(OH)_{2}D_{3}$.

Key words: Infants | Convulsion | Hypocalcemia | Vitamin D deficiency