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High Incidence, Early Onset, and Refractoriness to Supraphysiologic Doses of Calcitriol

Pankaja S. Venkataraman, MBBS; Reginald C. Tsang, MBBS; Jean J. Steichen, MD; Irene Grey, MD; Michael Neylan, MS; Alan R. Fleischman, MD

Am J Dis Child. 1986;140(10):1004-1008.

Abstract
• Nineteen preterm infants born at or before 32 weeks of gestation were studied to determine the dose of calcitriol that would be effective in the prophylaxis of early neonatal hypocalcemia (serum calcium level, <7.0 mg/dL [<1.75 mmol/L]). In these infants the course of early neonatal hypocalcemia was not modified by calcitriol administration. Serum 1,25-dihydroxyvitamin D level rose in response to intramuscular administration of calcitriol. The incidence of hypocalcemia in these infants was 37% by 12 hours, 83% by 24 hours, and 89% by 36 hours. Thus, in extremely preterm infants, the incidence of early neonatal hypocalcemia is higher and the onset earlier than in larger preterm infants; furthermore, in these infants the hypocalcemia is refractory even to high doses of calcitriol.

(AJDC 1986;140:1004-1008)

Author Affiliations
From the Division of Neonatology, Department of Pediatrics, University of Cincinnati Medical Center and Children's Hospital Medical Center, Cincinnati (Drs Venkataraman, Tsang, and Steichen); Division of Neonatology, Department of Pediatrics, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY (Dr Fleischman); and Ross Laboratories, Columbus, Ohio (Dr Grey and Mr Neylan). Dr Venkataraman is now with the University of Oklahoma Health Sciences Center, Oklahoma City.

Footnotes
Accepted for publication Oct 14, 1985.

Read in part before the Society for Pediatric Research, Washington, DC, May 4, 1983. Reprint requests to Department of Pediatrics, Neonatal Section, University of Oklahoma Health Sciences Center, PO Box 26901, Oklahoma City, OK 73190 (Dr Venkataraman).

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