ESPE2015 Poster Category 3 Bone (47 abstracts)
Comparison of Treatment Alternatives for Hypercalcemia due to Vitamin D Intoxication in Children
Korcan Demir a, , Hakan Döneray b , Ediz Yesilkaya c , Cengiz Kara d , Zeynep Atay e , Semra Çetinkaya f , Atilla Çayir g , Ahmet Anik a , Erdal Eren h , Fatma Demirel i , Gülay Can Yilmaz d , Ayca Torel Ergur j , Mustafa Kendirci k , Zehra Aycan f , Abdullah Bereket e , Murat Aydin d , Zerrin Orbak b & Behzat Özkan l
aDivision of Pediatric Endocrinology, Dokuz Eylül University, Izmir, Turkey; bDivision of Pediatric Endocrinology, Atatürk University, Erzurum, Turkey; cDivision of Pediatric Endocrinology, Gülhane Military Medical Academy, Ankara, Turkey; dDivision of Pediatric Endocrinology, On Dokuz Mayis University, Samsun, Turkey; eDivision of Pediatric Endocrinology, Marmara University, Istanbul, Turkey; fDivision of Pediatric Endocrinology, Sami Ulus Children’s Hospital, Ankara, Turkey; gDivision of Pediatric Endocrinology, Erzurum State Research and Training Hospital, Erzurum, Turkey; hDivision of Pediatric Endocrinology, Uludag University, Bursa, Turkey; iDivision of Pediatric Endocrinology, Children’s Hematology and Oncology Research and Training Hospital, Ankara, Turkey; jDivision of Pediatric Endocrinology, Kirikkale University, Kirikkale, Turkey; kDivision of Pediatric Endocrinology, Erciyes University, Kayseri, Turkey; lDivision of Pediatric Endocrinology, Dr Behçet Uz Children’s Hospital, Izmir, Turkey
Background: No large study comparing efficiency of prednisolone, alendronate and pamidronate has been conducted so far in children with hypercalcemia due to vitamin D intoxication.
Objective and hypotheses: To perform a multicentre, retrospective study assessing clinical characteristics and treatment results.
Method: A standard questionnaire was uploaded to an online national database system (www.favorsci.org) to collect data of children with hypercalcemia (serum calcium, >10.5 mg/dl) due to vitamin D intoxication (serum vitamin D, >150 ng/ml) who were treated in paediatric endocrinology clinics.
Results: 74 children (mean age 1.4±1.3 years, 45 males (60.8%)) from 11 canters were included. High doses of vitamin D intake was obvious in 77% of the cases. At diagnosis, mean calcium, vitamin D, and PTH levels were 15±3.2 mg/dl, 400±290 ng/ml, and 7.9±7.8 pg/ml respectively. Calcium levels showed only mild correlation with vitamin D levels (r=0.332, P=0.004). Patients were designated into five groups according to the initial treatment regimens (See Table). During follow-up, pamidronate and calcitonin treatments were also given in three and four cases, respectively, in group 2. Initial median calcium levels were similar (P=0.244) among groups 2, 3, and 4 allowing comparison for treatment efficiency. The time to achieve normocalcaemia was comparable (P=0.099) among groups 2, 3, and 4. However, recurrence rate of hypercalcemia was significantly lower in group 4 compared to groups 2 and 3 (0 (0%), 2 (25%), and 3 (30%) respectively, P=0.02).
Conclusion: In mild cases, hydration and furosemide are sufficient. For moderate cases, some of the patients given prednisolone require additional interventions (namely, pamidronate and calcitonin) to restore normocalcaemia. Pamidronate use is associated with a similar time to achieve normocalcaemia but with a lower recurrence rate. In severe hypercalcemia, physicians tended to start combination of treatments thus no comparison could be done with this group.
Funding: This work was supported by a grant from the Pediatric Endocrinology and Diabetes Society, Turkey (2014-000522).
Article tools
My recent searches
My recently viewed abstracts
Authors
ESPE Abstracts
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more