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Hypocalcemia

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Endocrine Conditions in Pediatrics

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Abstract

Hypocalcemia in infants and adolescents can present with mild or severe symptoms involving the nervous, cardiovascular, and/or skeletal systems. The hallmark manifestation is neuromuscular excitability with tetany, muscle spasm, and/or seizure, though mild hypocalcemia may be asymptomatic. The causes of hypocalcemia may be transient or permanent, and include genetic, autoimmune, nutritional, acquired, and iatrogenic etiologies. A focused history, thorough physical examination, and key laboratory studies are essential steps in the diagnostic pathways and help direct further evaluation and management.

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Abbreviations

AD:

Autosomal dominant

ADH:

Autosomal dominant hypocalcemia

AHO:

Albright’s hereditary osteodystrophy

AIRE:

Autoimmune regulator

APECED:

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome

AR:

Autosomal recessive

cAMP:

Cyclic adenosine monophosphate

CaSR:

Calcium-sensing receptor

CHD7:

Chromodomain helicase DNAbinding 7

EEG:

Electroencephalogram

EKG:

Electrocardiogram

FGF23:

Fibroblast growth factor 23

GATA3:

GATA-binding factor 3

GCM2:

Glial cell missing homologue 2

GNAS:

Guanine nucleotide–binding protein alpha subunit

HDR:

Hypoparathyroidism, sensorineural deafness, and renal disease

HVDRR:

Hereditary vitamin D–resistant rickets

MELAS:

Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes

MTP:

Mitochondrial trifunctional protein

PHP:

Pseudohypoparathyroidism

PTH:

Parathyroid hormone

RANK:

Receptor activator of nuclear factor kappa-B ligand

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Authors and Affiliations

  1. Department of Endocrinology, Massachusetts General Hospital, Boston, MA, USA

    Janaki D. Vakharia

  2. Department of Pediatric Endocrinology, Warren Alpert Medical School of Brown University and Hasbro Children’s Hospital, Providence, RI, USA

    Lisa Swartz Topor

Authors
  1. Janaki D. Vakharia
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Correspondence to Lisa Swartz Topor .

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Editors and Affiliations

  1. Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Takara Stanley

  2. Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Madhusmita Misra

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Vakharia, J.D., Topor, L.S. (2021). Hypocalcemia. In: Stanley, T., Misra, M. (eds) Endocrine Conditions in Pediatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-52215-5_5

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