9 causes and risk factors
Elevated levels of calcium in the blood indicate a condition known as hypercalcemia. The causes of high calcium levels may vary with age and other factors. High calcium levels in infants can be caused by the following factors:
- Excess calcium in food
- Excessive vitamin D intake leads to vitamin D intoxication. The active form of vitamin D can lead to the following consequences:
- Increased calcium resorption in kidneys
- Increased mineralization of bones
- Increased calcium absorption in the intestines
- Excessive vitamin A intake leads to increased calcium release from bone to blood
- Primary hyperparathyroidism or an increase in parathyroid hormone (PTH) is caused by an adenoma (enlargement or a benign growth or tumor) in parathyroid glands. This elevation in PTH can lead to the following:
- Increased release of calcium from bone to blood
- Decreased phosphate levels in the blood
- Increased activation of vitamin D
- Cancerous tumors can lead to the following:
- Bone invasion causing mineralization
- Secretion of certain substances that cause an increased release of calcium in the blood
- Injury to skin or fat tissue
- Infectious diseases, such as leprosy and histoplasmosis, wherein the release of immune cells may in turn activate vitamin D, causing vitamin D intoxication
- Immobilization or bed rest due to an illness leads to the decreased bone formation with a corresponding increase in calcium release in the blood.
- Family history of genetic disorders, such as
- Mutation(s) in calcium-sensing receptor gene CASR, which causes familial hypocalciuric hypercalcemia
- Williams syndrome
- Jansen’s metaphyseal chondrodysplasia
- Hypophosphatasia
- Congenital lactase deficiency
What is hypercalcemia?
Hypercalcemia is characterized by elevated levels of calcium in the blood. Although rare in children, hypercalcemia can cause severe symptoms in them.
Calcium levels are controlled by two hormones called parathyroid hormone and calcitonin. Vitamin D also plays an important role in balancing calcium levels in the body as it helps absorb calcium from food.
What are the signs and symptoms of high calcium levels in infants?
- Weakness
- Radiating lower abdominal pain (due to kidney stones)
- Bone pain
- Abdominal pain
- Nausea and vomiting
- Poor appetite
- Constipation
- Chronic fatigue/tiredness
- Excessive sleepiness
- Increased thirst
- Frequent urination, dehydration, and excessive thirst
- Confusion
- Muscle weakness
- Weight loss
- Headache
- Depression
Symptoms may vary based on the part of the body where it is affected. The following are the symptoms of hypercalcemia when it affects the nervous system
- Unsteady gait
- Headache
- Hallucinations
- Confusion
- Irritability
- Depression
Symptoms of hypercalcemia in the gastrointestinal system include
- Abdominal cramps
- Constipation
- Weight loss
- Nausea
- Vomiting
- Abdominal pain
Symptoms of hypercalcemia in the kidneys may include
- Kidney stones
- Increased thirst
- Frequent urination
- Kidney failure
Symptoms of hypercalcemia in the musculoskeletal system include
SLIDESHOW
Parenting Guide: Healthy Eating for Kids See SlideshowHow much calcium do children need?
The recommended amounts of calcium for different age groups are highlighted in the table below.
| Age group | Recommended servings | Daily calcium requirement |
|---|---|---|
| Younger than 6 months | not applicable | 200 mg |
|
6 months to 11 months |
not applicable | 260 mg |
| 1 to 3 years | 2 to 3 servings | 700 mg |
| 4 to 8 years | 2 to 3 servings | 1,000 mg |
| 9 to 18 years | 4 servings | 1,300 mg |
How is hypercalcemia treated in infants?
Mild cases of hypercalcemia do not require treatment and can be managed by the following:
- Increasing fluid intake
- Restricting calcium or vitamin D intake
- Changing the medications causing hypercalcemia
Treatment options for severe cases of hypercalcemia may include
- Forced excretion of calcium using saline and diuretics, such as furosemide
- Nitrogen-containing bisphosphonates, such as pamidronate, to avoid calcium loss from bones and osteoporosis
- Injection of calcitonin, which prevents calcium loss from bones and increases calcium excretion in urine
- Glucocorticoid treatment in children with excess vitamin D
- Surgery may be recommended to remove a tumor in the parathyroid gland
- Emergency medical attention may be required to prevent any further complications in infants, who have any underlying medical conditions that cause hypercalcemia
Medically Reviewed on 1/24/2023
References
Pediatric Hypercalcemia
https://emedicine.medscape.com/article/920955-overview
Calcium https://kidshealth.org/en/parents/calcium.html
Calcium https://kidshealth.org/en/parents/calcium.html
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