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Case Report
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| Symptomatic late onset hypocalcemia in a full term female neonate with vitamin D deficiency due to maternal hypovitaminosis D: A rare case report | ||||||
| Swathi Chacham1, Janampally Ravikiran2, Uppin Narayan Reddy3, Jillalla Narsing Rao4, Mahender Reddy5, Imeduddin6 | ||||||
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1MD Pediatrics, DM Neonatology (from PGIMER, Chandigarh), Associate Professor, Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India.
2MBBS, (MD, Pediatrics), Junior Resident, Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India. 3MD Pediatrics, Professor and Head, Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India. 4MD Pediatrics, Professor, Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India. 5MBBS, (MD, Pediatrics), Assistant Professor, Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India. 6MBBS, Dch Pediatrics, Senior Resident, Department of Pediatrics, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, Telangana, India. | ||||||
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| Chacham S, Ravikiran J, Reddy UN, Rao JN, Reddy M, Imeduddin. Symptomatic late onset hypocalcemia in a full term female neonate with vitamin D deficiency due to maternal hypovitaminosis D: A rare case report. Int J Case Rep Images 2015;6(5):276–279. |
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Abstract
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Introduction:
Neonatal hypocalcemia (NH) is a common metabolic complication in neonates, more so in premature and high risk neonates. It is classified as early and late neonatal hypocalcemia. Early NH occurs in the first 24–48 hours of life while the late NH is observed at the end of the first week. Vitamin D deficiency is an important cause for hypocalcemic seizures in neonates, in developing countries. High rate of skeletal growth coupled with low vitamin D stores and maternal vitamin D deficiency makes them vulnerable to vitamin D deficiency.
Case Report: A 2600 grams, term female neonate was born to a gravid 3 mother by C-section and had normal extra-uterine transition (APGAR score: 8&9 at 5 and 10 minutes of life). On eighth day of life, the neonate had multifocal clonic seizures with normal sensorium in between. No maternal risk factors were identified. There was no fever, lethargy, poor feeding, and clinical findings were unremarkable in the neonate. There was family history of neonatal seizures. Initial blood sugar and magnesium were normal. However, serum calcium levels were low (total 5.9 mg/dL, ionized 0.9 mg/dL) along with low phosphorous levels (1.7 mg/dL). Sepsis screen was negative, blood culture was sterile and cerebro spinal fluid analysis was normal. Similarly, neurosonogram, electroencephalogram, serum ammonia and lactate were normal, suggesting late onset hypocalcemic seizures. Both the neonatal and maternal vitamin D1 and 25-OH vitamin D were low, confirming maternal vitamin D deficiency causing neonatal vitamin D deficiency. The neonate responded to calcium and vitamin D supplementation with normal serum calcium levels in follow-up. Conclusion: We report a term, female neonate with late onset hypocalcemic seizures and vitamin D deficiency, due to maternal vitamin D deficiency. | |
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Keywords:
Neonatal hypocalcemia, Vitamin D deficiency, Seizures, Neonate
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Author Contributions
Swathi Chacham – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Janampally Ravikiran – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Uppin Narayan Reddy – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Jillalla Narsing Rao – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Mahender Reddy – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Imeduddin – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2015 Swathi Chacham et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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