Skip to main content
British Medical Journal logoLink to British Medical Journal
. 1969 Feb 22;1(5642):477–480. doi: 10.1136/bmj.1.5642.477

Oral Calcium-loading Test in Infancy, with Particular Reference to Idiopathic Hypercalcaemia

David G D Barr, John O Forfar
PMCID: PMC1982574  PMID: 5764249

Abstract

An oral calcium-loading test suitable for infants is described and the usual response defined. In four acute cases of idiopathic hypercalcaemia a high and sustained rise in serum calcium occurred, suggestive of hyperabsorption and consistent with a vitamin-D-like effect. In four further infants with a milder illness suggestive of hypercalcaemia the fasting calcium levels were not grossly raised, but the test produced an exaggerated hypercalcaemic response. In this type of patient the test is more sensitive in the diagnosis of idiopathic hypercalcaemia than isolated measurements of serum calcium, especially if these are taken in the fasting state. Five patients on treatment and three whose treatment had been discontinued (but who subsequently relapsed or made a poor recovery) showed abnormal loading tests at a time when fasting calcium levels were normal. In two cases full recovery from the disease was associated with reversion of the test to normal. The test can therefore be used to indicate activity of the disease and consequently as a guide to therapy. In two cases a persistently abnormal loading test was associated with a poor long-term prognosis.

Full text

PDF
477

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BLACK J. A., CARTER R. E. ASSOCIATION BETWEEN AORTIC STENOSIS AND FACIES OF SEVERE INFANTILE HYPERCALCAEMIA. Lancet. 1963 Oct 12;2(7311):745–749. doi: 10.1016/s0140-6736(63)90553-1. [DOI] [PubMed] [Google Scholar]
  2. CASSIMOS C., TSENGHI C., MICHAEL S., LIAROMATI A., METAXOTOU K. CONTINUOUS INTRAVENOUS INFUSION OF CALCIUM IN VITAMIN D DEFICIENT RICKETS. Pediatrics. 1963 Aug;32:272–279. [PubMed] [Google Scholar]
  3. FELLERS F. X., SCHWARTZ R. Etiology of the severe form of idiopathic hypercalcemia of infancy; a defect in vitamin D metabolism. N Engl J Med. 1958 Nov 27;259(22):1050–1058. doi: 10.1056/NEJM195811272592202. [DOI] [PubMed] [Google Scholar]
  4. FORFAR J. O., BALF C. L., MAXWELL G. M., TOMPSETT S. L. Idiopathic hypercalcaemia of infancy; clinical and metabolic studies with special reference to the aetiological role of vitamin D. Lancet. 1956 Jun 23;270(6930):981–988. doi: 10.1016/s0140-6736(56)91799-8. [DOI] [PubMed] [Google Scholar]
  5. FORFAR J. O., TOMPSETT S. L., FORSHALL W. Biochemical studies in idiopathic hypercalcaemia of infancy. Arch Dis Child. 1959 Dec;34:525–537. doi: 10.1136/adc.34.178.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. HARRISON H. E. Factors influencing calcium absorption. Fed Proc. 1959 Dec;18:1085–1092. [PubMed] [Google Scholar]
  7. Harris F., Hoffenberg R., Black E. Calcium kinetics in vitamin D deficiency rickets. I. Plasma kinetic studies after intravenous and oral Ca47. Metabolism. 1965 Oct;14(10):1101–1111. doi: 10.1016/0026-0495(65)90159-9. [DOI] [PubMed] [Google Scholar]
  8. Isaksson B., Lindholm B., Sjögren B. A critical evaluation of the calcium balance technic. II. Dermal calcium losses. Metabolism. 1967 Apr;16(4):303–313. doi: 10.1016/0026-0495(67)90041-8. [DOI] [PubMed] [Google Scholar]
  9. Isaksson B., Ohlsson L. A critical evaluation of the calcium balance technic. 3. The theoretical phosphorus balance. Metabolism. 1967 Apr;16(4):314–318. doi: 10.1016/0026-0495(67)90042-x. [DOI] [PubMed] [Google Scholar]
  10. Isaksson B., Sjögren B. A critical evaluation of the calcium balance technic. I. Variation in fecal output. Metabolism. 1967 Apr;16(4):295–302. doi: 10.1016/0026-0495(67)90040-6. [DOI] [PubMed] [Google Scholar]
  11. JONES K. H., FOURMAN P. Edetic-acid test of parathyroid insufficiency. Lancet. 1963 Jul 20;2(7299):119–121. doi: 10.1016/s0140-6736(63)92587-x. [DOI] [PubMed] [Google Scholar]
  12. JOSEPH R., MANDE R., JOB J. C., CORBIN J. L. [Primary hypophosphatemic vitamin-resistant rickets. Study of calcium metabolism with the aid of calcium 45]. Arch Fr Pediatr. 1963 Jun-Jul;20:699–714. [PubMed] [Google Scholar]
  13. KENNY F. M., ACETO T., Jr, PURISCH M., HARRISON H. E., HARRISON H. C., BLIZZARD R. M. Metabolic studies in a patient with idiopathic hypercalcemia of infancy. J Pediatr. 1963 Apr;62:531–537. doi: 10.1016/s0022-3476(63)80010-4. [DOI] [PubMed] [Google Scholar]
  14. LOWE C. E., BIRD E. D., THOMAS W. C., Jr Hypercalcemia in myxedema. J Clin Endocrinol Metab. 1962 Mar;22:261–267. doi: 10.1210/jcem-22-3-261. [DOI] [PubMed] [Google Scholar]
  15. MITCHELL R. G. The prognosis in idiopathic hypercalcaemia of infants. Arch Dis Child. 1960 Aug;35:383–388. doi: 10.1136/adc.35.182.383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. MORGAN H. G., MITCHELL R. G., STOWERS J. M., THOMSON J. Metabolic studies on two infants with idiopathic hypercalcaemia. Lancet. 1956 Jun 16;270(6929):925–931. doi: 10.1016/s0140-6736(56)91518-5. [DOI] [PubMed] [Google Scholar]
  17. Peacock M., Knowles F., Nordin B. E. Effect of calcium administration and deprivation on serum and urine calcium in stone-forming and control subjects. Br Med J. 1968 Jun 22;2(5607):729–731. doi: 10.1136/bmj.2.5607.729. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. VAANDRAGER G. J., WEYERS H. A. PRIMARY VITAMIN D-REFRACTORY RICKETS. III. THE CALCIUM INFUSION TEST AS A MEANS OF DETERMINING THE FUNCTION OF THE PARATHYROID GLANDS. Ann Paediatr. 1963;201:287–295. [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES