Calcium homeostasis in premature infants and treatment of early hypocalcaemia by 1,25-dihydroxycholecalciferol.

We studied calcium homeostasis and the serum calcium response to oral 1,25-dihydroxycholecalciferol [1,25 (OH)2D3] at a low pharmacological dosage of 0.1 microgram/kg daily in 14 early hypocalcaemic asymptomatic neonates. Seven hypocalcaemic neonates were not treated. In hypocalcaemic neonates serum PTH levels were normal, the urinary C-AMP response after PTH stimulation was poor and plasma 1,25 (OH)2D3 was low. Treatment with 1,25(OH)2D3 resulted in a rapid increase of serum calcium. The increase was more rapid in neonates treated with 1,25(OH)2D3 than in untreated subjects. A similar result was obtained in one of a pair of identical twins. These results suggest that a low dose of 1,25(OH)2D3 is effective in treating neonatal hypocalcaemia. However, the response was delayed for 48 h. The reason for this delay is not clear.