Hypocalcaemia induced by glucocorticoids in a child with hypoparathyroidism treated with 1-alpha-hydroxyvitamin D3.
Glucocorticoids tend to lower the intestinal absorption of calcium, leading to a negative calcium balance. A 7-year-old girl with hypoparathyroidism was maintained as normocalcaemic on 1-alpha-hydroxyvitamin D3 (1 alpha D3) and calcium gluconate lactate. During an episode of aplastic anaemia she was treated with prednisolone, with a subsequent dramatic fall of serum calcium despite 1 alpha D3 treatment and serum 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in the high-normal range. Glucocorticoids seem to have interfered directly with cellular events responsible for intestinal absorption of calcium.
D000741:Anemia, Aplastic / Q000150:complications / Q000188:drug therapy; D002118:Calcium / Q000378:metabolism; D002125:Calcium Gluconate / Q000627:therapeutic use; D002648:Child; D003864:Depression, Chemical; D004347:Drug Interactions; D005260:Female; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use*; D006996:Hypocalcemia / Q000139:chemically induced*; D007011:Hypoparathyroidism / Q000150:complications / Q000188:drug therapy*; D007408:Intestinal Absorption / Q000187:drug effects; D011239:Prednisolone / Q000009:adverse effects* / Q000627:therapeutic use
D006887:Hydroxycholecalciferols; D011239:Prednisolone; D002125:Calcium Gluconate; D002118:Calcium; C008088:alfacalcidol