Prevalence of Transient Hyperphosphatasemia Among Healthy Infants and Toddlers

Huh, Susanna Y.; Feldman, Henry A.; Cox, Joanne E.; Gordon, Catherine M.

doi:10.1542/peds.2008-3093

Cited by 55 publications

(83 citation statements)

References 25 publications

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“…Five percent of the children in the cohort had transient hyperphosphatasemia which is similar to other published reports in a similar age group [34].…”

Section: Discussionsupporting

confidence: 90%

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Utility of Urine Calcium and Phosphate as Screening Tools for Vitamin D Deficiency in ChildrenMatthew R. Benson

Benson¹,

Black²,

Olney³

2012

Pediatr Therapeut

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Objective: Vitamin D deficiency is estimated to affect one billion people worldwide. In the United States, 9-12% of healthy children have vitamin D deficiency. Renal calcium and phosphate excretion in healthy people is a sensitive indicator of total body mineral balance. We explored the possibility of using urine calcium-to-creatinine (U ca /U cr ) and urine phosphate-to-creatinine (U phos /U cr ) as noninvasive biomarkers of vitamin D deficiency in at risk children. Patients and methods:This was an observational study of children with one or more risk factors for vitamin D deficiency. Anthropometric data and a physical exam were obtained in all children and skin pigmentation, sunlight exposure, dietary history, and frequency of vitamin supplementation of both mother and child were determined by parent report. We measured serum levels of calcium, phosphate, magnesium, intact PTH, 25-hydroxyvitamin D, alkaline phosphatase, and creatinine.A random urine sample was collected for calcium, phosphate and creatinine.Results: A total of 60 healthy children were recruited. Mean age of the subjects was 1.4 (range 0.5 to 2.9) years. Twenty percent of the children were regularly given vitamin D supplements. The prevalence of vitamin D deficiency (25-hydroxyvitamin D < 50 nmol/L) was 3.4%, vitamin D insufficiency (≥ 50 and < 80 nmol/L) was 28.6% and vitamin D sufficiency (≥ 80 nmol/L) was 68%. One subject had biochemical evidence of rickets. Linear regression analysis showed no correlation between 25-hydroxyvitamin D levels and random U ca /U cr or U phos /U cr . Conclusion:Random urine calcium or phosphate levels offer little promise as screening tools for vitamin D deficiency in children.

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“…Five percent of the children in the cohort had transient hyperphosphatasemia which is similar to other published reports in a similar age group [34].…”

Section: Discussionsupporting

confidence: 90%

“…His bones did not show active rickets radiographically. Five percent of the children in the cohort also had transient hyperphosphatasemia [34]. This was confirmed in these cases by repeat alkaline phosphatase testing with the subjects primary physician.…”

Section: Resultsmentioning

confidence: 66%

Utility of Urine Calcium and Phosphate as Screening Tools for Vitamin D Deficiency in ChildrenMatthew R. Benson

Benson¹,

Black²,

Olney³

2012

Pediatr Therapeut

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“…2 The prevalence of BTH is estimated to be between 1.5% and 5.1% in infants and small children. 4,5 Serum levels of ALP >1000 U/L (3 times the upper limit of normal) were documented in 2.8% of the children, most of them younger than age 2 years. 4 Moderate elevations of serum ALP (400-1,000 U/L) were found in 5.1% of the study participants.…”

Section: Epidemiologic and Clinical Datamentioning

confidence: 99%

An 18-Month-Old Boy with Diarrhea and an Elevated Biochemical Parameter

Shapira¹,

Shaoul²

2015

Pediatr Ann

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A n 18-month-old boy presented to his primary care pediatrician with a complaint of diarrhea for the past 5 days. The diarrhea was frequent, watery, but without mucus or blood. The diarrhea was not associated with vomiting, fever, cough, or skin rash. His past medical history is significant only for mild asthma, and his immunizations are up-to-date.The physical examination revealed an alert, well-developed boy with a weight of 11.9 kg (54th percentile), height of 84.5 cm (77th percentile), and normal vital signs. His abdomen was soft, nontender, and without hepatosplenomegaly or signs of dehydration. The rest of the physical examination was normal.A clinical diagnosis of viral gastroenteritis was made and oral rehydration therapy and dietary modifications were recommended. After 3 days he returned to the clinic because of the persistence of the diarrhea, and there were still no other symptoms. Once again, the results of his physical examination were normal. Because of the continuation of the diarrhea, laboratory tests (blood, urine, and stool) were performed, and the results were as follows: hemoglobin, 11.5 g/dL; white blood cells, 9.2 10 3 /mcL; platelets, 367 10 3 /mcL (with a normal differential count); C-reactive protein, <0.5 mg/dL; glucose, 75 mg/dL; urea, 25 mg/dL; creatinine, 0.20 mg/dL; potassium, 4.3 nmol/L; sodium, 138 nmol/L; protein, 6.2 g/dL; albumin, 4.1 g/dL; bilirubin, 0.20 mg/dL; ferritin, 20 ng/mL; asparate aminotransferase, 37 U/L; alanine aminotransferase, 26 U/L; gamma-glutamyl transpeptidase, 5 U/L; calcium, 9.3 mg/dL; and phosphorus, 4.9 mg/dL. Urinalysis was normal, and stool for culture, ova, parasites, Giardia lamblia antigen, rotavirus, and adenovirus was negative. Blood serology was negative for Epstein-Barr virus (EBV), hepatitis C, and for immunoglobulin M cytomegalovirus (CMV) antibodies, and positive for immunoglobulin G CMV antibodies, indicating a past infection with CMV.An elevated biochemical parameter in the blood revealed a condition that may be associated with the clinical presentation (gastroenteritis) described, appearing mainly in infancy and early childhood.

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“…[51][52][53][54][55][56] The Z-score is a dimensionless quantity generated by subtracting a Generating expected growth curves WR Riddle and SC DonLevy population mean (m) from the raw value (x), then dividing by the population standard deviation (s).…”

Section: Z-scoresmentioning

confidence: 99%

Generating expected growth curves and Z-scores for premature infants

Riddle

DonLevy

2010

J Perinatol

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Objective: To establish a standard for expected growth of premature infants and generate Z-scores based on the standard.Study Design: Multiple regression and analysis of variance were used to evaluate whether the 10th, 50th, and 90th percentiles of birth weight, head circumference, and length from other studies were statistically different from the percentiles from Riddle. Z-scores were generated from the 10th, 50th, and 90th percentiles.Result: The growth charts from Mead-Johnson, Babson, Williams, Alexander, Usher, Yudkin, and Fenton were not coincident with the values reported by Riddle. The percentiles reported by Thomas were statistically coincident with the percentiles reported by Riddle. Conclusion:The regression equations for the 10th, 50th, and 90th percentile for weight, head circumference, and length provide expected growth of premature infants. The equations can be used to generate expected growth curves and Z-scores for weight, head circumference, and length of premature infants.

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Prevalence of Transient Hyperphosphatasemia Among Healthy Infants and Toddlers

Cited by 55 publications

References 25 publications

Utility of Urine Calcium and Phosphate as Screening Tools for Vitamin D Deficiency in ChildrenMatthew R. Benson

Utility of Urine Calcium and Phosphate as Screening Tools for Vitamin D Deficiency in ChildrenMatthew R. Benson

An 18-Month-Old Boy with Diarrhea and an Elevated Biochemical Parameter

Generating expected growth curves and Z-scores for premature infants

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