Dysregulation of calcium homeostasis after severe burn injury in children

Possible role of magnesium depletion

G. L. Klein, M. Nicolai, C. B. Langman, B. F. Cuneo, D. E. Sailer, David Herndon

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Objective: To determine the cause and extent of hypocalcemia observed in children after severe burns. Design: We studied 10 children with burns covering 57% ± 17% (SD) body surface area, ages 9.6 ± 4.7 years, who were admitted consecutively during a 6-month period. Diet supplied a minimum of 2.7 gm/m2 of calcium, 0.3 gm/m2 of magnesium, and 2.2 gm/m2 phosphate. Blood specimens were obtained daily for 10 ± 5 days for the following tests: (1) simultaneous analysis for ionized calcium, magnesium, and intact parathyroid hormone (group A); (2) two of these children, randomly selected, had serial 2-hour determinations on a single day (group B); (3) a modified Ellsworth-Howard test, consisting of a 10-minute infusion of synthetic parathyroid hormone 18 ± 10 days postburn and associated changes in urinary cyclic adenosine monophosphate excretion and renal threshold phosphate concentration (group C). Three of these children, when normomagnesemic, also received a standard magnesium infusion to determine magnesium retention (group D). Data were analyzed with chi-square, regression analysis, and nonparametric testing as appropriate. Results: All patients showed sustained hypocalcemia and hypomagnesemia; intact parathyroid hormone response was inappropriately low and response to synthetic parathyroid hormone infusion was blunted. Lowest ionized calcium levels were associated with hypomagnesemia. Conclusion: Hypoparathyroidism and blunted renal response to parathyroid hormone suggest that magnesium depletion may contribute to their pathogenesis. Magnesium repletion and monitoring are recommended.

Original languageEnglish (US)
Pages (from-to)246-251
Number of pages6
JournalJournal of Pediatrics
Volume131
Issue number2
DOIs
StatePublished - 1997

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Magnesium
Parathyroid Hormone
Homeostasis
Calcium
Wounds and Injuries
Hypocalcemia
Burns
Phosphates
Hypoparathyroidism
Body Surface Area
Cyclic AMP
Regression Analysis
Diet
Kidney

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Dysregulation of calcium homeostasis after severe burn injury in children : Possible role of magnesium depletion. / Klein, G. L.; Nicolai, M.; Langman, C. B.; Cuneo, B. F.; Sailer, D. E.; Herndon, David.

In: Journal of Pediatrics, Vol. 131, No. 2, 1997, p. 246-251.

Research output: Contribution to journalArticle

Klein, G. L. ; Nicolai, M. ; Langman, C. B. ; Cuneo, B. F. ; Sailer, D. E. ; Herndon, David. / Dysregulation of calcium homeostasis after severe burn injury in children : Possible role of magnesium depletion. In: Journal of Pediatrics. 1997 ; Vol. 131, No. 2. pp. 246-251.
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