Background Hypercalcaemia can cause life-threatening complications. Pharmacological treatment of severe hypercalcaemia is complicated by lack of experience with some effective medicines such as bisphosphonates in newborns.
Purpose To describe the pharmacotherapeutic management of pamidronate in severe hypercalcaemia of a premature newborn.
Material and methods We report on a preterm infant [weight: 1.080 kg, length 38 cm] who had required total parenteral nutrition (TPN) since birth. In routine blood tests, serum calcium was 15.6 mg/dl on the seventh day of life, reaching as high as 17.2 mg/dl as a consequence of suspected adrenal insufficiency of central origin.
Results Hypercalcaemia persisted despite the conventional treatment for excessive calcium, including removal of calcium from the TPN. The patient received intravenous pamidronate (1 mg/kg) for 1 day. Pamidronate 6 mg was diluted in 30 millilitres of 5% dextrose saline solution, only 10 millilitres were infused in 4 h. His serum calcium level decreased significantly, and about 15 h later, his total calcium level normalised (10.6 mg/dl). His serum calcium concentration returned to normal without any adverse reactions.
Conclusion Intravenous pamidronate appeared to be a safe and effective treatment for severe hypercalcaemia in a premature newborn.
References and/or acknowledgements To my pharmacist colleagues.
No conflict of interest.
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