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2015 ; 20
(2
): 86-91
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Clinical and laboratory characteristics of neonatal hypocalcemia
#MMPMID26191512
Cho WI
; Yu HW
; Chung HR
; Shin CH
; Yang SW
; Choi CW
; Kim BI
Ann Pediatr Endocrinol Metab
2015[Jun]; 20
(2
): 86-91
PMID26191512
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PURPOSE: To describe the clinical characteristics of full-term neonates with
hypocalcemia and to suggest factors associated with neonatal hypocalcemia.
METHODS: The medical records of full-term neonates with hypocalcemia were
reviewed. Hypocalcemia was defined as an ionized calcium (iCa) concentration of
<4 mg/dL. Parathyroid hormone (PTH) insufficiency was defined as a serum PTH
level of <60 pg/mL or a serum phosphorus level higher than the serum calcium
level in the presence of hypocalcemia. RESULTS: Fifty-three neonates were
enrolled. The median age at diagnosis of hypocalcemia was 3 days. In all the
neonates, formula feeding predominance was observed. Thirty-eight neonates
(69.8%) were compatible with PTH insufficiency. The number of formula-fed
neonates was significantly higher than that of breast-fed patients among neonates
with PTH insufficiency (P=0.017). Intact PTH was negatively correlated with serum
phosphorus levels. Twelve out of 14 neonates (85.7%) had 25-hydroxy vitamin D
(25OHD) levels <20 ng/mL and 9 neonates (64.3%) had 25OHD levels <10 ng/mL.
Twenty-one neonates had hypocalcemic tetany. The serum calcium and iCa
concentrations of neonates with tetany were 4.2-8.3 mg/dL and 1.85-3.88 mg/dL,
respectively. Three neonates showed symptomatic hypocalcemia with calcium levels
over 7.5 mg/dL. Among the 16 neonates who underwent electroencephalography (EEG),
12 had abnormalities, which normalized after 1-2 months. CONCLUSION: Formula milk
feeding, PTH insufficiency and low serum vitamin D concentration are associated
with the development of neonatal hypocalcemia. Symptoms such as tetany and QT
interval prolongation can develop in relatively mild hypocalcemia. Moreover,
transient neonatal hypocalcemia can cause transient EEG abnormalities.
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