Low calcium tetany in the newborn: A review of the literature and a report of a case

Abstract

Summary 1.A case of low calcium tetany in a newborn infant is reported. Facial twitchings first occurred on the second day of life during the course of aspiration pneumonia. Twitchings recurred on the seventh day of life and again on the eighth day, followed by convulsion. The blood calcium content was 7.6 mg. Intensive therapy was instituted. Although symptoms of active tetany ceased after the third day of therapy, the blood calcium content was relatively unchanged (7.5 mg.) at the end of a week of therapy and was raised to 9.3 mg. only after two weeks of intensive intravenous and oral calcium therapy. Vitamin D in the form of viosterol was given to increase the absorption of calcium through the intestinal tract. 2.This is the second proved case of low calcium tetany in the newborn during the first three weeks of life observed by the author within a period of fifteen months. 3.The presence or absence of the Chvostek phenomenon is not of diagnostic significance. Although laryngospasm and carpopedal spasm may be present, they must not necessarily form part of the symptom-complex. The occurrence of convulsions or twitchings of unexplained etiology in a newborn infant, even in the absence of other signs and symptoms of tetany, necessitates a blood calcium determination to establish or rule out low calcium tetany. 5.The increasing frequency of reports of low calcium tetany in the newborn is obviously not due to an increased incidence of the syndrome but rather to increased watchfulness on the part of the physician and routine blood calcium determinations in cases of convulsions or twitches of unexplained etiology in the newborn. 6.If the calcium content of the blood were determined routinely in all such infants, it is probable that low calcium tetany would be found much more commonly in the newborn period than has hitherto been the case.