Current Paediatrics
Volume 13, Issue 7 , Pages 529-535, December 2003

Disorders of calcium metabolism

  • Jeremy Allgrove

      Affiliations

    • Corresponding Author InformationCorrespondence to: JA. Tel.: +44(0) 020 7363 8462; Fax: +44(0) 20 7363 8081

Consultant Paediatric Endocrinologist and Honorary Senior Lecturer, St Bartholomew's and the Royal London Hospitals, Whitechapel, London E1 1BB and Newham General Hospital, Glen Road, Plaistow, London E13 8RU, UK

Abstract 

Calcium is crucial for normal neuromuscular activity. It also has a structural role as a component of bone where most of it is present. Plasma calcium is dependent on two main hormones, 1,25-dihydroxyvitamin D and parathyroid hormone, and their interactions with gut absorption, renal excretion and bone mineralization. Disorders of calcium metabolism may result in both hypo- and hypercalcaemia. In children, the former is more common than the latter.

Vitamin D undergoes two hydroxylation steps before becoming active. Deficiency or a defect in its metabolism results in rickets, hypocalcaemia or both. Parathyroid hormone is secreted by the parathyroid glands in response to hypocalcaemia under the influence of calcium-sensing receptors. Deficiency of, or failure to respond to, this hormone results in hypocalcaemia, and excess secretion causes hypercalcaemia. Abnormalities of calcium-sensing receptors cause both hypo- and hypercalcaemia.

Treatment is directed towards maintaining normal calcium concentrations whilst preventing hypercalciuria.

Keywords:  calcium, phosphate, 1,25-dihydroxyvitamin D, parathyroid hormone, calcium sensing receptor, pseudohypoparathyroidism, hypoparathyroidism, hypercalcaemia, hypocalcaemia, magnesium

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PII: S0957-5839(03)00104-0

doi:10.1016/j.cupe.2003.08.007

Current Paediatrics
Volume 13, Issue 7 , Pages 529-535, December 2003

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