Case Study of Infant Highlights Importance of Considering Rare Entity in Hypercalcemia Diagnosis

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Researchers note the importance of including rare entity in diagnosis of hypercalcemia.
Researchers note the importance of including rare entity in diagnosis of hypercalcemia.

(HealthDay News) — A rare case of immobility-induced hypercalcemia in an infant has been documented in a case report published in Pediatrics.

Neha Vyas, MD, from the Rainbow Babies and Children's Hospital in Cleveland, and colleagues describe a case of an infant with hypercalcemia who presented with fatigue, irritability, and failure to thrive after prolonged immobilization.

The authors present the case of a 2-month-old female infant with a history of bladder exstrophy, an anteriorly displaced anus, and bilateral hip dysplasia who underwent reconstruction of her midline structures on day 11 of life. She was placed in a hip spica cast from day 11 to day 42, and was noted to have increased irritability after removal of the cast. 

On day 53, she presented to the emergency department with visible signs of fatigue, irritability, and failure to regain birth weight. Hypercalcemia was revealed on laboratory evaluation. 

The patient was managed with intravenous hydration and switched from exclusive breastfeeding to a low-calcium, vitamin D-free formula, and after not tolerating the switch was changed to breastfeeding with Similac Sensitive formula supplementation. 

Resolution of the hypercalcemia occurred at day 3 of hospitalization. After showing stable calcium levels and steady weight gain the patient was discharged on day 12 of hospitalization.

"This case highlights the importance of including this rare entity in a differential diagnosis of hypercalcemia as well as screening postsurgical patients with prolonged immobility for hypercalcemia," the researchers wrote.

Reference

  1. Vyas N, Kaminski B, MacLeish S. A Rare Case Report of Immobility-Induced Hypercalcemia in an Infant. Pediatrics. 2016. doi:10.1542/peds.2015-0879.
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