HYPERCALCITONEMIA AND NEONATAL HYPOCALCEMIA

Abstract

Serum immunoreactive caldtonin (iCT) was measured in 160 full-term and premature normocalcemic and hypocalcemic infants during the first 96 hours of life. The mean ± S.E. of serum iCT in cord blood of normal full-term infants was 150 ± 26 (normal in older subjects <150 pg/ml). After birth the mean serum iCT increased sharply and reached a peak of over 600 pg/ml between 13 and 24 hours of age during the period of decline of serum Ca from relatively high cord values. After 36 hours of age there was a progressive decrease in mean serum iCT to 178 pg/ml at 73-96 hours of age. Though somewhat higher in premature infants, the serum iCT was, in general, inversely related to serum Ca in infants of all gestational ages. The mean serum iCT during the first 96 hours of life (excluding cord blood) in hypocalcemic infants of all gestational ages was approximately twice the mean value of normocalcemic infants (1055 pg/ml vs. 510 pg/ml, p<.01). The incidence of serum iCT greater than 800 pg/ml was 19% in serum samples from normocalcemic infants, as compared to 74% in hypocalcemic infants. On the other hand, serum iCT less than 300 pg/ml were found in 43% of samples from normocalcemic infants, as compared to less than 6% in hypocalcemic infants. The elevated iCT found in the newborn is consistent with the report of increased C-cells and calcitonin concentration in the human neonatal thyroid. The accumulated evidence indicates that hypercalcitonemia warrants serious consideration as a factor in the pathogenesis of neanatal hypocalcemia.

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