| Late infantile tetany and secondary hyperparathyroidism in infants fed humanized cow milk formula. Longitudinal follow-up. | |
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MedLine Citation:
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PMID: 3874538 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Five full-term infants with birth weights appropriate for gestational age presented with hypocalcemic tetany at 5 to 9 days of age. All infants had been fed Similac 20, a cow milk formula. Initial mean serum calcium (Ca), phosphorus (P), and magnesium (Mg) levels of the tetanic infants were 6.8, 9.5, and 1.6 mg/dL, respectively. The mean serum parathyroid hormone (PTH) level was elevated at 79 mu LEq/mL (adult normal values, less than or equal to 57 mu LEq/mL). Following restoration of normocalcemia with Ca supplements, feeding was reinstituted with Similac 20 in two infants and Similac PM 60/40 in three infants. Serum biochemical and hormonal values were compared with those of 18 exclusively breast-fed infants followed up from three weeks to six months and 14 Similac 20-fed full-term infants followed up from one week to six months. In tetanic infants, serum Ca concentrations became elevated (10.4 +/- 0.05 mg/dL; mean +/- SEM) by six weeks (vs 9.2 +/- 0.3 mg/dL in breast-fed infants) (P less than .001) and serum Mg concentrations (2.26 +/- 0.01 mg/dL) by four weeks (vs 1.92 +/- 0.07 mg/dL in breast-fed infants) (P less than .01). Mean serum P concentrations declined progressively. Mean serum PTH concentrations were elevated and ranged from 74 to 143 mu LEq/mL at two to 16 weeks (vs mean 28 to 35 mu LEq/mL in breast-fed infants (P less than .0001). In 14 formula-fed-nontetanic full-term infants, serum PTH concentrations were intermediate between formula-fed-tetanic and breast-fed infants, mean serum Ca concentrations ranged from 10.2 to 10.4 mg/dL, and mean serum P concentrations declined from 8.3 to 7.1 mg/dL. We speculate that acute hypocalcemic tetany in the study infants was induced by the relatively high P load in cow milk formulas (vs human milk); with the continued P load, secondary hyperparathyroidism continued, maintaining P, Ca, and Mg homeostasis. |
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Authors:
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P S Venkataraman; R C Tsang; F R Greer; A Noguchi; P Laskarzewski; J J Steichen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of diseases of children (1960) Volume: 139 ISSN: 0002-922X ISO Abbreviation: Am. J. Dis. Child. Publication Date: 1985 Jul |
Date Detail:
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Created Date: 1985-08-01 Completed Date: 1985-08-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0370471 Medline TA: Am J Dis Child Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 664-8 Citation Subset: AIM; IM |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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25-Hydroxyvitamin D 2 Animals Breast Feeding Calcitonin / blood Calcitriol / blood Calcium / blood, therapeutic use Cattle Ergocalciferols / analogs & derivatives, blood Humans Hyperparathyroidism, Secondary / etiology* Infant Food / adverse effects* Infant, Newborn Longitudinal Studies Magnesium / blood Milk Parathyroid Hormone / analysis Phosphorus / blood Tetany / drug therapy, etiology* |
| Chemical | |
Reg. No./Substance:
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0/Ergocalciferols; 0/Parathyroid Hormone; 21343-40-8/25-Hydroxyvitamin D 2; 32222-06-3/Calcitriol; 7439-95-4/Magnesium; 7440-70-2/Calcium; 7723-14-0/Phosphorus; 9007-12-9/Calcitonin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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