hypercalcemia

Today, we're discussing a 10-month-old with vomiting and hypercalcemia. Despite two weeks of illness, the vomiting resolved for some time.Here, we see the patient's growth curves for weight and length. At 9 months, the patient's weight was 7.39 kg, and length was 66.7 cm, showing a notable increase.Let's examine the patient's vitals. The temperature was 36.1°C, and heart rate was 144 bpm. This overview helps us understand the current status.Here's a detailed look at the lab results. We see the patient's white-cell count is 17,030, and hemoglobin is 12.5 g/dL, among other crucial markers.After two days, the patient's vomit increased. The ultrasound showed a normal pylorus, but the GI series revealed a hypertrophic pyloric stenosis.This section delves into potential genetic disorders, including hypophosphatasia and Jansen's Metaphyseal Chondrodysplasia, which could be linked to hypercalcemia.We're discussing Idiopathic Infantile Hypercalcemia. This is due to a 25-hydroxyvitamin D level in the upper end of normal range, and we don't know the cause.Here's a diagnostic flowchart. Hypercalcemia can be due to a low parathyroid hormone level, and normal 25-hydroxyvitamin D evaluates the active form.This diagram illustrates Vitamin D metabolism. Sunlight exposure and dietary intake of calcium and vitamin D are crucial, with various pathways leading to active 1,25(OH)2D.Again, we focus on vitamin D metabolism. This shows the active form, 1,25(OH)2D, and its interaction with CYP27B1, which is key in understanding hypercalcemia.