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- Title
Comparison of Treatment Regimens in Management of Severe Hypercalcemia Due to Vitamin D Intoxication in Children.
- Authors
Demir, Korcan; Döneray, Hakan; Kara, Cengiz; Atay, Zeynep; Çetinkaya, Semra; Çayır, Atilla; Anık, Ahmet; Eren, Erdal; Uçaktürk, Ahmet; Yılmaz, Gülay Can; Ergür, Ayça Törel; Kendirci, Mustafa; Aycan, Zehra; Bereket, Abdullah; Aydın, Murat; Orbak, Zerrin; Özkan, Behzat
- Abstract
Objective: No large study has been conducted to date to compare the effectiveness of prednisolone, alendronate and pamidronate as first-line treatment in children with hypercalcemia due to vitamin D intoxication. The aim was to perform a multicenter, retrospective study assessing clinical characteristics and treatment results. Methods: A standard questionnaire was uploaded to an online national database system to collect data on children with hypercalcemia (serum calcium level >10.5 mg/dL) due to vitamin D intoxication [serum 25-hydroxyvitamin D (25(OH)D) level >150 ng/mL] who were treated in pediatric endocrinology clinics. Results: Seventy-four children [median (range) age 1.06 (0.65-1.60) years, 45 males (61%) from 11 centers] were included. High-dose vitamin D intake was evident in 77% of the cases. At diagnosis, serum calcium, phosphorus, alkaline phosphatase, 25(OH)D and parathyroid hormone concentrations were 15±3.2 mg/dL, 5.2±1.2 mg/dL, 268±132 IU/L, 322 (236-454) ng/mL, and 5.5 (3-10.5) pg/ mL, respectively. Calcium levels showed moderate correlation with 25(OH)D levels (rs=0.402, p<0.001). Patients were designated into five groups according to the initial specific treatment regimens (hydration-only, prednisolone, alendronate, pamidronate, and combination). Need for another type of specific drug treatment was higher in children who initially received prednisolone (p<0.001). Recurrence rate of hypercalcemia was significantly lower in children who were treated with pamidronate (p=0.02). Conclusion: Prednisolone is less effective in the treatment of children with severe hypercalcaemia secondary to vitamin D intoxication and timely implementation of other treatment regimens should be considered.
- Subjects
DIPHOSPHONATES; ALENDRONATE; PREDNISOLONE; ALKALINE phosphatase; CALCIUM; HYPERCALCEMIA; MEDICAL cooperation; PARATHYROID hormone; PHOSPHORUS; QUESTIONNAIRES; RESEARCH; VITAMIN D; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; CHILDREN; THERAPEUTICS
- Publication
Journal of Clinical Research in Pediatric Endocrinology, 2019, Vol 11, Issue 2, p140
- ISSN
1308-5727
- Publication type
Article
- DOI
10.4274/jcrpe.galenos.2018.2018.0131