title: Hypercalcemia, hypercalciuria and nephrocalcinosis in a breast-fed term newborn: a rare presentation.
abstract: Although hypercalcemia and hypercalciuria are known to occur in breast-fed pre-term infants, to the best of our knowledge, it has never been reported in a term baby previously. We report a term male baby who was followed-up during pregnancy for having bright kidneys, but a follow-up renal ultrasound (US) after birth had revealed normal scan. Laboratory investigations revealed normal serum calcium (Ca), phosphorous (PO₄) and alkaline phosphatase (ALP). The baby was being fed by breast milk. Follow-up US two months later showed early nephrocalcinosis along with hypercalcemia and hypercalciuria; by the age of three months, nephrocalcinosis was more extensive and the serum Ca level was more than 12 mg/L with hypercalciuria. Parathyroid hormone (PTH), phosphorous (PO₄), ALP and thyroid function tests were all normal. Antenatal history revealed a hypothyroid mother who was maintained on L-thyroxin, calcium and vitamin D supplement during pregnancy. Her blood tests showed normal serum Ca, low PO₄ and elevated PTH. The baby was diagnosed to have hypercalciuria and hypercalcemia secondary to maternal hypophosphatemia (maternal vitamin D deficiency). Breast feeding was stopped and the baby was started on formula, whereby he showed remarkable improvement both for his blood chemistry as well as his hypercalciuria.
authors: Pediatric Department, Queen Rania Abdulla Children Hospital, Amman, Jordan.
authors: Issa A
authors: IA
authors: Hazza
authors: Manahil S
authors: MS
authors: Ghandour
authors: Reham I
authors: RI
authors: Almardini
authors: Rana E
authors: RE
authors: Haddad
authors: Ghazi M
authors: GM
authors: Salaita
mesh_terms: D001903:Bottle Feeding; D001942:Breast Feeding; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000151:congenital* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D017674:Hypophosphatemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D007223:Infant; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D009397:Nephrocalcinosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D009752:Nutritional Status; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000628:therapy