Investigation and Management of Hypercalcaemia in Children
Investigation and Management of Hypercalcaemia in Children
Hypercalcaemia may be observed incidentally in asymptomatic children. In these children, the first step is simply to repeat the test to confirm the result and monitor the trend in calcium levels. In symptomatic cases or if there is evidence of end-organ damage, investigations should be instituted immediately.
A number of investigations should be taken at the time of hypercalcaemia and prior to any treatment, as PTH levels, which are dependent on plasma calcium levels, are key to the subsequent management steps ( Box 1 ). To establish the underlying diagnosis quickly, it is helpful to consider the causes of hypercalcaemia as either PTH dependent or PTH independent ( Box 2 and Box 3 ).
Investigation of a Child With Hypercalcaemia
Hypercalcaemia may be observed incidentally in asymptomatic children. In these children, the first step is simply to repeat the test to confirm the result and monitor the trend in calcium levels. In symptomatic cases or if there is evidence of end-organ damage, investigations should be instituted immediately.
A number of investigations should be taken at the time of hypercalcaemia and prior to any treatment, as PTH levels, which are dependent on plasma calcium levels, are key to the subsequent management steps ( Box 1 ). To establish the underlying diagnosis quickly, it is helpful to consider the causes of hypercalcaemia as either PTH dependent or PTH independent ( Box 2 and Box 3 ).
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