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Hypocalcemia, Pediatric

Mary Scott Ramnitz, MD and Alison Boyce, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Hypocalcemia refers to calcium levels below the normal range for age.

  • The severity of hypocalcemia varies from mild and asymptomatic to acutely life-threatening.

  • Identifying the etiolo...

DIAGNOSIS

HISTORY

  • For neonates and infants: detailed maternal and birth history

  • Dietary history (particularly calcium, vitamin D intake)

  • History of neck surgery/radiation

  • Family history of calcium disorde...

TREATMENT

  • Acute symptomatic hypocalcemia (all calcium doses expressed in respective salt amounts unless specified):

    • Calcium gluconate (preferred) 100 to 200 mg/kg/dose (max 1 to 2 g/dose) IV over 5 to ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Regular serum and urine monitoring during initial therapy and dose adjustments

  • Ongoing monitoring as indicated depending on the etiology of hypoc...

ADDITIONAL READING

  • Liamis G, Milionis HJ, Elisaf M. A review of drug-induced hypocalcemia. J Bone Miner Metab.  2009;27(6):635–642. [View Abstract on OvidInsights]

  • Lima K, Abrahamsen TG, Wolff AB,...

CODES

ICD9

  • 275.41 Hypocalcemia

  • 775.4 Hypocalcemia and hypomagnesemia of newborn

ICD10

  • E83.51 Hypocalcemia

  • P71.1 Other neonatal hypocalcemia

  • P71.0 Cow’s milk hypocalcemia in newborn

  • P71.8 Oth transitory neona...

FAQ

  • Q: How can the phosphorus concentration help establish the cause of hypocalcemia?

  • A: In addition to increasing serum calcium, PTH results in renal phosphate wasting. Therefore, in settings of incre...

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