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2021 May 12

Ann Pediatr Endocrinol Metab

Immobilization induced symptomatic hypercalcemia treated with zoledronate in a child with a left ventricular assist device.


Gün E, Kendirli T, Botan E, Uçar T, Aycan Z, Akar A R
Ann Pediatr Endocrinol Metab. 2021 May 12.
PMID: 34015907.


Differential diagnosis of hypercalcemia in children includes hyperthyroidism, infection, inflammatory processes, malignant tumors. Immobilization-induced hypercalcemia is rare in healthy individuals; it can occur in adolescent males, especially after a fracture. Immobility caused increased skeletal calcium release and hypercalcemia, and this condition is also known as resorptive hypercalcemia. We present here a 10-year-old adolescent girl with advanced heart failure who underwent HeartMate 3 (HM3) left ventricular assist device (LVAD) implantation. She had symtomps abdominal pain, vomiting, and constipation on the 5th month of hospitalization. She subsequently developed immobilization-induced symptomatic hypercalcemia (serum calcium, 12.1 mg/dL; corrected calcium 12.8 mg/dL; parathormone (PTH), 1.9 pg/mL; calcium/creatinine ratio in spot urine, 1.21). Hypercalcemia is uncommon in children with advanced heart failure (HF). The bisphosphonate therapy was initiated because our patient did not respond to hydration and furosemide treatment, and she had abdominal pain, vomiting, and constipation. The patient's complaints were resolved on the second day after administrating bisphosphonate and hypercalcemia did not recur.