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A Case of Nephrotic Syndrome With Tetany
Author(s) -
Tanaka Toshiaki,
Yano Hisako,
Lin Kakoh,
Nagai Megumi,
Akagi Kunihiko,
Yoshiwara Shoji
Publication year - 1984
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.1984.tb01821.x
Subject(s) - medicine , tetany , hyperventilation , calcium , endocrinology , urine , calcium metabolism , vitamin d and neurology
A 7‐year‐old girl with nephrotic syndrome had several attacks of tetany during the relapses. The attacks, acccompanied by hyperventilation, responded to re‐breathing with a vinyl bag. However, other episodes of attacks which were not accompanied by hyperventilation, did not respond to re‐breathing but responded to the intravenous administration of calcium gluconate. The serum concentrations of total calcium and ionized calcium were low and no calcium‐binding protein was found in the serum from the patient, using chromatographic study. The serum concentration of 1, 25(OH) 2 vitamin D was within the normal range, but showed a tendency for the value to be lower in relapse than in remission. Urinary, Ca/Cr ratio in relation to serum calcium was high in this patient and a low threshold of calcium excretion in the kidney was demonstrated. It is suggested that the impaired vitamin D metabolism and calcium loss in the urine might have contributed to tetany in this patient. Administration of a calcium preparation and vitamin D may be necessary for a frequentrelapser on long‐term glucocorticoid therapy.