Ip Patrick
Department of Paediatrics, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road, Hong Kong, People's Republic of China.
Arch Gynecol Obstet. 2003 Aug;268(3):227-9. doi: 10.1007/s00404-002-0316-5. Epub 2002 May 14.
Neonatal convulsion is a very alarming manifestation of underlying sinister problem. As an important cause, neonatal hypocalcemia usually occurs soon after birth and reflects abnormal maternal calcium regulation. We report an unusual case of late neonatal hypocalcemia presented with intractable seizures after two-month-old. Further investigations revealed maternal hyperparathyroidism secondary to parathyroid adenoma, which was missed during antenatal checkup. High index of suspicion is necessary in early detection and prompt treatment of neonatal hypocalcemia. Screening of maternal calcium level is mandatory in unexplained late neonatal hypocalcemia as mother with primary hyperparathyroidism could be asymptomatic and first manifest as late-onset neonatal convulsion. Early detection and appropriate intervention could avoid serious maternal and fetal morbidity.
新生儿惊厥是潜在严重问题的一种非常令人担忧的表现。作为一个重要原因，新生儿低钙血症通常在出生后不久发生，反映了母体钙调节异常。我们报告了一例不寻常的晚发性新生儿低钙血症病例，该患儿在两个月大时出现难治性惊厥。进一步检查发现母亲患有继发于甲状旁腺腺瘤的甲状旁腺功能亢进症，这在产前检查中被漏诊。在早期发现和及时治疗新生儿低钙血症方面，高度的怀疑指数是必要的。对于不明原因的晚发性新生儿低钙血症，必须筛查母体钙水平，因为患有原发性甲状旁腺功能亢进症的母亲可能没有症状，最初表现为迟发性新生儿惊厥。早期发现和适当干预可以避免严重的母婴发病。
