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

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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

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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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