Hypocalcaemia following therapy of thyrotoxicosis in an infant

Abstract

A 2‐mo‐old infant born to a mother with Graves’ disease and having symptoms of thyrotoxicosis was started on antithyroid drugs. Life‐threatening hypocalcaemia requiring high‐dose calcium infusions developed 1 mo after starting therapy. Serum alkaline phosphatase and paratharmone levels were elevated. This communication may serve to alert treating physicians about this rare complication in infants with thyrotoxicosis after initiation of antithyroid therapy. Conclusion: Severe hypocalcaemia may follow initiation of antithyroid therapy in infants with thyrotoxicosis.

Neonatal Grave’s disease: a caution while treating

“…The initiation of anti-thyroid drugs may lead to excessive bone remineralization resulting in hungry bone syndrome (HBS), characterized by hypocalcemia, hypophosphatemia, and hypomagnesemia (3). Severe hypocalcemia due to HBS may manifest as laryngospasm, tetany, and cardiac dysfunction (3,4). This condition is relatively common in adults and may occur within hours to months following medical or surgical therapy of hyperthyroidism (3,6).…”

“…An early recognition of HBS following anti-thyroid therapy and prompt institution of therapy is crucial for a successful outcome (3,4). For acute management, highdose calcium infusion is given until serum calcium normalizes and symptoms resolve (4,5).…”

“…For acute management, highdose calcium infusion is given until serum calcium normalizes and symptoms resolve (4,5). Oral mineral supplementation may have to be continued for prolonged periods in some cases (5).…”