Dysregulation of calcium homeostasis after severe burn injury in children: possible role of magnesium depletion.

Klein GL, Nicolai M, Langman !, uneo !", #ailer D$, %erndon DN. Department of Pediatrics, University of Texas Medical Branch, Galveston 77555-0 5!, U"#$

%B&'(T)*'+ To determine the ca,se and extent of hypocalcemia o-served in children after severe -,rns$ D'")G.+ /e st,died 00 children 1ith -,rns coverin2 573 45- 073 6"D7 -ody s,rface area, a2es 8$9 45- :$7 years, 1ho 1ere admitted consec,tively d,rin2 a 9-month period$ Diet s,pplied a minim,m of !$7 2m5m! of calci,m, 0$ 2m5m! of ma2nesi,m, and !$! 2m5m! phosphate$ Blood specimens 1ere o-tained daily for 00 45- 5 days for the follo1in2 tests+ 607 sim,ltaneo,s analysis for ioni;ed calci,m, ma2nesi,m, and intact parathyroid hormone 62ro,p #7< 6!7 t1o of these children, randomly selected, had serial !-ho,r determinations on a sin2le day 62ro,p B7< 6 7 a modified 'lls1orth-=o1ard test, consistin2 of a 00-min,te inf,sion of synthetic parathyroid hormone 0> 45- 00 days post--,rn and associated chan2es in ,rinary cyclic adenosine monophosphate excretion and renal threshold phosphate concentration 62ro,p (7$ Three of these children, 1hen normoma2nesemic, also received a standard ma2nesi,m inf,sion to determine ma2nesi,m retention 62ro,p D7$ Data 1ere analy;ed 1ith chi-s?,are, re2ression analysis, and non-parametric testin2 as appropriate$

&$#'L(#: #ll patients sho1ed s,stained hypocalcemia and hypoma2nesemia< intact parathyroid hormone response 1as inappropriately lo1 and response to synthetic parathyroid hormone inf,sion 1as -l,nted$ @o1est ioni;ed calci,m levels 1ere associated 1ith hypoma2nesemia$ )N L'#*)N+ =ypoparathyroidism and -l,nted renal response to parathyroid hormone s,22est that ma2nesi,m depletion may contri-,te to their patho2enesis$ Ma2nesi,m repletion and monitorin2 are recommended$
PM)D+ 8!80900 AP,-Med - indexed for M'D@).'B

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