Hypocalcemia—a complication of childhood leukemia

Sixteen episodes of hypocalcemia (serum calcium below 7.2 mg/100 ml) were detected in 14 of 135 children (10.4%) hospitalized for acute leukemia. Acute renal shut-down was responsible for 5 episodes. The etiology of the other episodes cannot be determined with certainty, and the role of sepsis, blood and platelet transfusions, renal and gastrointestinal malfunction, corticosteroids, hormonal dysfunction, and chemotherapeutic agents is discussed. Therapy consisted of repeated intravenous infusions of calcium gluconate. In 2 patients with associated hypomagnesemia, elevation of the serum calcium was achieved only after the administration of magnesium sulfate. Two patients failed to respond. The death of 7 patents within several days of the recognition of hypocalcemia suggests that it may be an ominous finding.