title: Life-threatening Dilated Cardiomyopathy Induced by Late-onset Neonatal Hypocalcemia.
abstract: Neonatal seizures caused by hypocalcemia may be associated with cardiopulmonary dysfunction and may require specific management other than calcium supplementation. Severe dilated cardiomyopathy is an extremely rare complication in neonatal hypocalcemia and often results in high morbidity and mortality. We report here a 14-day-old neonate presenting with a gradually increasing frequency of tonic seizures. After admission, arterial desaturation was found despite supplying oxygen (4 L/min) through nasal prongs and the patient developed life-threatening respiratory distress and heart failure secondary to dilated cardiomyopathy. His critical cardiopulmonary derangements rapidly improved after respiratory support, the administration of diuretic and inotropic drugs, and the correction of his hypocalcemia and hypomagnesemia. The patient responded to treatment and was well during the 1-year follow-up period. We present this unique case history of seizure, respiratory distress, and heart failure induced by transient hypocalcemia to remind clinicians about the importance of this rare, life-threatening, but reversible, disorder.
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Po-Ching
authors.initials: PC
authors.lastname: Chou
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Lung-Chang
authors.initials: LC
authors.lastname: Lin
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Jong-Hau
authors.initials: JH
authors.lastname: Hsu
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Pediatrics, Faculty of Medicine and Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Rei-Cheng
authors.initials: RC
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Yuh-Jyh
authors.initials: YJ
authors.lastname: Jong
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Pediatrics, Faculty of Medicine and Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Zen-Kong
authors.initials: ZK
authors.lastname: Dai
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Pediatrics, Faculty of Medicine and Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: jirewu@kmu.edu.tw.
authors.forename: Jiunn-Ren
authors.initials: JR
authors.lastname: Wu
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006996:Hypocalcemia / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D007231:Infant, Newborn; D008297:Male
keywords: cardiopulmonary failure; critical care; dilated cardiomyopathy; neonatal hypocalcemia; seizures