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Humoral hypercalcaemia in an infant : a diagnostic dilemma
Hypercalcaemia is seldom encountered in paediatric patients, and calcium levels are not routinely included in investigations. Associated symptoms such as nausea, vomiting, dehydration and abdominal pain are non-specific, thus sustained hypercalcaemia may result in delipidating calcifications, neurological and renal impairment. Physiologically, primary role players in calcium metabolism include parathyroid hormone (PTH) and vitamin D3 (calcitriol). It is important to establish whether hypercalcaemia is PTH or non-PTH related so that targeted treatment may be planned