Calcium-free hemodialysis for hypercalcemia of malignancy in a newborn.
Hypercalcemia associated with malignancy is very rare in the newborn period. Severe hypercalcemia causes neurological and cardiological disturbances and can be life threatening. Calcium-free hemodialysis has not been reported for the treatment of malignancy associated hypercalcemia in neonates. We report a 5-day-old infant with severe hypercalcemia (serum calcium 22 mg/dl) secondary to a solid tumor in the pelvis. Aggressive pharmacological treatment with furosemide, pamidronate, and calcitonin failed to reduce the serum calcium adequately. Implementation of calcium-free hemodialysis resulted in a rapid reduction of the serum calcium from 22.6 mg/dl to 11.6 mg/dl. Hemodialysis was well tolerated with no hemodynamic complications. Continuous veno-venous hemodialysis was used to maintain normocalcemia.
Pradhan
Madhura
M
Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. pradhan@email.chop.edu
Leonard
Mary B
MB
D002118:Calcium / Q000097:blood; D015312:Hemodialysis Solutions / Q000008:administration & dosage*; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology* / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D010281:Parathyroid Hormone / Q000378:metabolism; D010386:Pelvic Neoplasms / Q000150:complications* / Q000378:metabolism; D006435:Renal Dialysis / Q000379:methods*
D015312:Hemodialysis Solutions; D010281:Parathyroid Hormone; D002118:Calcium