A Rare Case Report of Immobility-Induced Hypercalcemia in an Infant

Abstract

Immobility-induced hypercalcemia is a rare cause of hypercalcemia in children, and to our knowledge it has never been reported in an infant. Infants and children are in a state of high bone turnover. Therefore, they are prone to the imbalance of osteoblastic and osteoclastic activity that occurs with prolonged immobilization, leading to hypercalcemia. Here we present the case of an infant with hypercalcemia who presented with fatigue, irritability, and failure to thrive after prolonged immobilization. Therapeutic interventions were conservative and included hydration and increased mobility leading to complete resolution. This case highlights the importance of including this rare entity in a differential diagnosis of hypercalcemia as well as screening postsurgical patients with prolonged immobility for hypercalcemia.

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

“…Albright also reported that the skeletal structure was exposed to many stresses, hormonal and nutritional effects during normal activity (10). Excessive reduction in mechanical stress on the bone reduces osteoblast-mediated bone formation and accelerates osteoclast-mediated bone absorption (8,9). During this separation of bone formation, and resorption, a minority of patients develop severe hypercalcemia, which can affect renal…”

“…Although this is rare among patients who can move freely, immobilization can be a cause of hypercalcemia among patients in the intensive care unit. Differential diagnosis of hypercalcemia includes hyperthyroidism, infection, inflammatory processes, prolonged immobilization (>2 weeks), or malignant tumors [ 1 , 3 , 8 ]. Immobilization-induced hypercalcemia is rare in healthy individuals, although it can occur in adolescent males, especially after a fracture [ 1 ].…”

“…A r t i c l e function (9). Immobility caused by increased skeletal Ca release and hypercalcemia, and this condition is also known as resorptive hypercalcemia (8).…”

Nephrolithiasis as a Complication of Immobilization Induced Hypercalcemia

“…Most of the cases were described in adult patients, however it was noted that this condition is more common in children and adolescents in whom bone turnover is high. One literature described a rare case of immobility-induced hypercalcemia in a 2-month-old female infant [2]. The management of hypercalcemia depends on the level of severity.…”

“…Infants and children are in a state of high bone turnover. Therefore, they are prone to the imbalance of osteoblastic and osteoclastic activity that occurs with prolonged immobilization, leading to hypercalcemia [2]. Immobilization hypercalcemia diagnosis requires an evaluation to rule out hypercalcemia causes.…”