Document Detail


Metabolic bone disease of prematurity and secondary hyperparathyroidism.
MedLine Citation:
PMID:  21392146     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim:  To illustrate, via case histories, the importance of laboratory investigations for the early diagnosis and management of metabolic bone disease (MBD). Methods:  We report three cases of extreme premature infants with MBD. Results:  These three infants had several risk factors for MBD of prematurity: very low birthweight, delayed enteral feeds, cholestatic liver disease, intolerance of fortification, the use of glucocorticoids and diuretics. Serum alkaline phosphatase and parathyroid hormone (PTH) were elevated despite relatively normal calcium and phosphate levels. These parameters were corrected with additional supplementation of calcium, phosphate and vitamin D. Conclusions:  Infants born extremely prematurely have significant calcium and phosphate depletion by the time they reach full term compared with the normal fetal accretion rate. This is exacerbated if there is poor tolerability to feeds where extra calcium and phosphate could not be added either by additives or via human milk fortifier. Serum calcium and phosphate levels may be normal despite inadequate intake or stores due to the counter-regulatory effect of PTH. In infants at risk of MBD, testing serum alkaline phosphatase, vitamin D and PTH with calcium and phosphate may assist in the monitoring and management of MBD.
Authors:
Ashish Lothe; John Sinn; Monique Stone
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-10
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  -     ISSN:  1440-1754     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
Affiliation:
Departments of Neonatology Paediatric Endocrinology, Royal North Shore Hospital The University of Sydney, Sydney, New South Wales, Australia.
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