What happens when blood calcium level becomes low or high in newborn and children

           
            Calcium is essential for maintaining the electrolyte balance in our body. More than half of the body calcium is present in the mass composition of the bones. Calcium is needed for some normal physiological functions like muscle contraction, blood coagulation and neuromuscular signal transmission. Vitamin-D and some hormones play an important role in calcium absorption from the dietary foods. Let know what happens when serum (blood) calcium level becomes low or high in newborn and children.


           The normal range of plasma calcium level is 9-11 mg/dl.

HYPOCALCEMIA

           If the serum calcium level goes less than 8 mg/dl, then it is called hypocalcemia.

Causes of hypocalcemia:

  •  preterm and prematurity
  •  infant of a diabetic mother
  •  vitamin-D resistance and it's metabolic disorder
  •  parathyroid gland abnormality
  •  prolonged drug therapy with frusemide or phenytoin
  •  low level of other electrolytes like magnesium.

CLINICAL FEATURES

IN NEWBORN: 
           poor breastfeeding, vomiting, jitteriness, inactive and sometimes seizures can occur.

IN CHILDREN:
           spasm of muscle, seizures, central nervous irritability and depression may also occur.

MEDICAL MANAGEMENT:

           Consult a paediatrician immediately if the infant or child has these symptoms.

           A required dose of 10% calcium gluconate is given intravenously under monitoring heart function.


HYPERCALCEMIA

           If the serum calcium level measured more than the normal value that is above 11 mg/dl. It is called as hypercalcemia.

           Normally hypercalcemia is asymptomatic and the symptoms are seen only when the level goes more than 13 mg/dl.

Causes and clinical features:

            In newborn, it is due to hyperparathyroidism (increased function of parathyroid gland) and also due to excessive intake of calcium-rich dietary foods.
            In most of the case, the baby is asymptomatic and may vomit or have seizures.

            In children, the cause is same as newborn and may also due to some malignancies like Hodgkin lymphoma or Ewing sarcoma.
            Some symptoms like muscle weakness, constipation, depression, mental confusion, decreased muscle tone and other cardiac signs.

MANAGEMENT OF HYPERCALCEMIA includes hydration to increase urinary calcium excretion. If parathyroid gland disorder is detected than surgical options may be needed.

           For more details, consult your family paediatrist.

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