Document Detail

Late infantile tetany and secondary hyperparathyroidism in infants fed humanized cow milk formula. Longitudinal follow-up.
MedLine Citation:
PMID:  3874538     Owner:  NLM     Status:  MEDLINE    
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.
P S Venkataraman; R C Tsang; F R Greer; A Noguchi; P Laskarzewski; J J Steichen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  1985-08-01     Completed Date:  1985-08-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370471     Medline TA:  Am J Dis Child     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  664-8     Citation Subset:  AIM; IM    
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MeSH Terms
25-Hydroxyvitamin D 2
Breast Feeding
Calcitonin / blood
Calcitriol / blood
Calcium / blood,  therapeutic use
Ergocalciferols / analogs & derivatives,  blood
Hyperparathyroidism, Secondary / etiology*
Infant Food / adverse effects*
Infant, Newborn
Longitudinal Studies
Magnesium / blood
Parathyroid Hormone / analysis
Phosphorus / blood
Tetany / drug therapy,  etiology*
Reg. No./Substance:
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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