Hypercalcemia in children and adolescents

被引:80
作者
Lietman, Steven A. [1 ]
Germain-Lee, Emily L. [2 ,3 ]
Levine, Michael A. [4 ,5 ]
机构
[1] Cleveland Clin, Orthopaed & Rheumatol Inst, Cleveland, OH 44106 USA
[2] Johns Hopkins Univ, Sch Med, Div Pediat Endocrinol, Baltimore, MD USA
[3] Bone Ctr & Osteogenesis Imperfecta Program, Kennedy Krieger Inst, Baltimore, MD USA
[4] Childrens Hosp Philadelphia, Div Endocrinol & Diabet, Philadelphia, PA 19104 USA
[5] Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA USA
基金
美国国家卫生研究院;
关键词
bisphosphonates; hypercalcemia; hyperparathyroidism; pediatrics; CALCIUM-SENSING RECEPTOR; FAMILIAL HYPOCALCIURIC HYPERCALCEMIA; NEONATAL SEVERE HYPERPARATHYROIDISM; CHROMATIN-REMODELING COMPLEX; SUBCUTANEOUS FAT NECROSIS; ALKALINE-PHOSPHATASE; VITAMIN-D; SECONDARY HYPERPARATHYROIDISM; INFANTILE HYPOPHOSPHATASIA; INACTIVATING MUTATION;
D O I
10.1097/MOP.0b013e32833b7c23
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose of review In this review, we define hypercalcemia levels, common causes for hypercalcemia in children, and treatment in order to aid the practicing pediatrician. Recent findings One rare cause of hypercalcemia in the child is familial hypocalciuric hypercalcemia (also termed familial benign hypercalcemia). Mutations that inactivate the Ca2+-sensing receptor gene FHH have been described as an autosomal dominant disorder, but recently milder mutations in the CASR have been shown to cause hypercalcemia when homozygous. Summary Normal serum levels of calcium are maintained through the interplay of parathyroid, renal, and skeletal factors. In this review, we have distinguished the neonate and infant from the older child and adolescent because the causes and clinical features of hypercalcemia can differ in these two age groups. However, the initial approach to the medical treatment of severe or symptomatic hypercalcemia is to increase the urinary excretion of calcium in both groups. In most cases, hypercalcemia is due to osteoclastic bone resorption, and agents that inhibit or destroy osteoclasts are, therefore, effective treatments. Parathyroid surgery, the conventional treatment for adults with symptomatic primary hyperparathyroidism, is recommended for all children with primary hyperparathyroidism.
引用
收藏
页码:508 / 515
页数:8
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