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Population-Based Incidence of Potentially Life-Threatening Complications of Hypocalcemia and the Role of Vitamin D Deficiency.
J Pediatr 2019; 211:98-104.e4JPed

Abstract

OBJECTIVES

To determine the incidence of potentially life-threatening complications of hypocalcemia in infants and children in Olmsted County, Minnesota; and to determine if vitamin D deficiency contributed to these events and was, at the time of clinical presentation, considered as a possible cause.

STUDY DESIGN

In this population-based descriptive study, data were abstracted from the Rochester Epidemiology Project, a medical record linkage system covering 95% of patients in Olmsted County, Minnesota. Participants were children aged 0-5 years who resided in Olmsted County between January 1, 1996 and June 30, 2017, and who received diagnoses of seizures, cardiomyopathy, cardiac arrest, respiratory arrest, laryngospasm, and/or tetany. The incidence of hypocalcemia plus a potentially life-threatening complication was calculated.

RESULTS

Among 15 419 patients aged 0-5 years in Olmsted County during the study period, 1305 had eligible complications: 460 had serum calcium checked within 14 days of presentation and 85 had hypocalcemia. Patients were excluded when causes other than hypocalcemia likely triggered the complication, leaving 16 children whose complication was attributed to hypocalcemia. Three of these 16 patients had a serum 25-hydroxyvitamin D measurement and 2 were deficient (≤6 ng/mL [15 nmol/L]). Among children aged 0-5 years, the incidence of hypocalcemia plus a potentially life-threatening complication was 6.1 per 100 000 person-years (95% CI, 3.5-10.0).

CONCLUSIONS

Vitamin D deficiency is an underinvestigated cause of complications of hypocalcemia in children. Serum calcium and 25-hydroxyvitamin D should be measured in children with these complications to identify possibly life-threatening vitamin D deficiency.

Authors+Show Affiliations

Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN.Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.Department of Family Medicine, Mayo Clinic, Rochester, MN.Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.Department of Family Medicine, Mayo Clinic, Rochester, MN.Department of Family Medicine, Mayo Clinic, Rochester, MN.Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.Department of Family Medicine, Mayo Clinic, Rochester, MN. Electronic address: Thacher.Thomas@mayo.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30954245

Citation

Aul, Andrea J., et al. "Population-Based Incidence of Potentially Life-Threatening Complications of Hypocalcemia and the Role of Vitamin D Deficiency." The Journal of Pediatrics, vol. 211, 2019, pp. 98-104.e4.
Aul AJ, Fischer PR, O'Grady JS, et al. Population-Based Incidence of Potentially Life-Threatening Complications of Hypocalcemia and the Role of Vitamin D Deficiency. J Pediatr. 2019;211:98-104.e4.
Aul, A. J., Fischer, P. R., O'Grady, J. S., Mara, K. C., Maxson, J. A., Meek, A. M., ... Thacher, T. D. (2019). Population-Based Incidence of Potentially Life-Threatening Complications of Hypocalcemia and the Role of Vitamin D Deficiency. The Journal of Pediatrics, 211, pp. 98-104.e4. doi:10.1016/j.jpeds.2019.02.018.
Aul AJ, et al. Population-Based Incidence of Potentially Life-Threatening Complications of Hypocalcemia and the Role of Vitamin D Deficiency. J Pediatr. 2019;211:98-104.e4. PubMed PMID: 30954245.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Population-Based Incidence of Potentially Life-Threatening Complications of Hypocalcemia and the Role of Vitamin D Deficiency. AU - Aul,Andrea J, AU - Fischer,Philip R, AU - O'Grady,Jason S, AU - Mara,Kristin C, AU - Maxson,Julie A, AU - Meek,Alicia M, AU - Petterson,Tanya M, AU - Thacher,Tom D, Y1 - 2019/04/04/ PY - 2018/11/28/received PY - 2019/01/17/revised PY - 2019/02/13/accepted PY - 2020/08/01/pmc-release PY - 2019/4/8/pubmed PY - 2019/4/8/medline PY - 2019/4/8/entrez KW - 25-hydroxyvitamin D KW - calcium KW - cardiac arrest KW - cardiomyopathy KW - laryngospasm KW - respiratory arrest KW - seizure KW - tetany SP - 98 EP - 104.e4 JF - The Journal of pediatrics JO - J. Pediatr. VL - 211 N2 - OBJECTIVES: To determine the incidence of potentially life-threatening complications of hypocalcemia in infants and children in Olmsted County, Minnesota; and to determine if vitamin D deficiency contributed to these events and was, at the time of clinical presentation, considered as a possible cause. STUDY DESIGN: In this population-based descriptive study, data were abstracted from the Rochester Epidemiology Project, a medical record linkage system covering 95% of patients in Olmsted County, Minnesota. Participants were children aged 0-5 years who resided in Olmsted County between January 1, 1996 and June 30, 2017, and who received diagnoses of seizures, cardiomyopathy, cardiac arrest, respiratory arrest, laryngospasm, and/or tetany. The incidence of hypocalcemia plus a potentially life-threatening complication was calculated. RESULTS: Among 15 419 patients aged 0-5 years in Olmsted County during the study period, 1305 had eligible complications: 460 had serum calcium checked within 14 days of presentation and 85 had hypocalcemia. Patients were excluded when causes other than hypocalcemia likely triggered the complication, leaving 16 children whose complication was attributed to hypocalcemia. Three of these 16 patients had a serum 25-hydroxyvitamin D measurement and 2 were deficient (≤6 ng/mL [15 nmol/L]). Among children aged 0-5 years, the incidence of hypocalcemia plus a potentially life-threatening complication was 6.1 per 100 000 person-years (95% CI, 3.5-10.0). CONCLUSIONS: Vitamin D deficiency is an underinvestigated cause of complications of hypocalcemia in children. Serum calcium and 25-hydroxyvitamin D should be measured in children with these complications to identify possibly life-threatening vitamin D deficiency. SN - 1097-6833 UR - https://www.unboundmedicine.com/medline/citation/30954245/Population-Based_Incidence_of_Potentially_Life-Threatening_Complications_of_Hypocalcemia_and_the_Role_of_Vitamin_D_Deficiency L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(19)30242-2 DB - PRIME DP - Unbound Medicine ER -