Department of Medical General Ward, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China.
Endocrine. 2023 Jul;81(1):175-181. doi: 10.1007/s12020-023-03347-1. Epub 2023 Mar 10.
Hypercalcemic crisis is considered a critical and fatal endocrine condition. To date, few reports have focused on hypercalcemic crises in children.
To explore the etiology and identify the clinical characteristics related to hypercalcemic crises in children.
We enrolled 101 children diagnosed with hypercalcemia between January 1, 2016 and December 31, 2021, admitted to the Children's Hospital of Chongqing Medical University. Electronic medical records were reviewed to determine the causes and clinical characteristics of hypercalcemic crises.
Hypercalcemic crises occurred in 28 admissions during the 6-year period; 64% of the patients enrolled in the study were infants. The mean corrected total serum calcium was 4.6 ± 0.2 mmol/l. Tumor and hereditary diseases were found in 12 (43%) and 7 (25%) patients, respectively. The ratio of iatrogenic factors was 11% (3/28), and all 3 patients received a blood transfusion. The incidence of poor prognosis in the tumor cases was 50%. Timely intervention including hemodialysis, pamidronate, and etiological treatment was effective in decreasing calcium levels.
Hypercalcemic crisis is a serious electrolyte disturbance that has the potential for high mortality. The main causes are tumors and hereditary diseases in children. The lack of unique characteristics makes it difficult to recognize by medical caregivers. Early diagnosis and timely intervention could improve the prognosis.
高钙血症危象被认为是一种严重的致命性内分泌疾病。迄今为止，很少有报道关注儿童的高钙血症危象。
探讨儿童高钙血症危象的病因，并确定与高钙血症危象相关的临床特征。
我们纳入了 2016 年 1 月 1 日至 2021 年 12 月 31 日期间在重庆医科大学儿童医院诊断为高钙血症的 101 例儿童患者。回顾电子病历以确定高钙血症危象的病因和临床特征。
在 6 年期间共发生 28 例高钙血症危象住院；研究中纳入的患者 64%为婴儿。校正后的总血清钙平均值为 4.6±0.2mmol/L。肿瘤和遗传性疾病分别在 12 例（43%）和 7 例（25%）患者中发现。医源性因素的比例为 11%（3/28），所有 3 例患者均接受了输血。肿瘤患者的预后不良发生率为 50%。包括血液透析、帕米膦酸和病因治疗在内的及时干预措施可有效降低血钙水平。
高钙血症危象是一种严重的电解质紊乱，具有高死亡率的潜在风险。主要病因是儿童的肿瘤和遗传性疾病。由于缺乏独特的特征，使得医疗护理人员难以识别。早期诊断和及时干预可改善预后。
