A Case of Osteosclerosis with Hypercalcaemia and Renal Failure

Disorders of calcium metabolism in childhood (except rickets) were regarded as uncommon until the recognition by Lightwood (1952) of the syndrome of 'idiopathic hypercalcaemia of infants with failure to thrive'.Previously there had been occasional reports of children considered to have Albers- Schonberg disease, hypervitaminosis D, primary hyperparathyroidism (Pratt, Geren and Neuhauser, 1947; Philips, 1948) and hyperparathyroidism with renal disease (Andersen and Schlesinger, 1942).Albers-Schonberg disease is generally regarded as not causing hypercalcaemia, renal damage or ectopic calcification, but these may occur in the other conditions.Some of the patients described in the literature do not apparently belong to any of these groups.For example, Lightwood (1932) reported a dwarf with mental retardation, osteosclerosis, calcinosis, arterial degeneration and renal damage.Butler (1951) described a similar condition.Idiopathic hypercalcaemia is regarded by some as occurring in both mild and severe forms, though the latter may be a separate syndrome (Lightwood and Stapleton, 1953).There are patients who show only some of the features of the fully developed severe form and there appears to be a continuous spectrum between the extremes.It is possible that some of the cases described in the older reports were examples of the severe form, and the same is true of this patient.Case History L.B.G.H. (No. 11038), a boy, born on September 28, 1952, was admitted on August 6, 1955, aged 2 years 10 months.The family history was not remarkable; there was one healthy sibling two years older than the patient.His mother had taken the usual supplements during her pregnancy, and delivery was normal at full term.Except for feeding difficulties and an unusual diet the child developed normally until his final illness.He had bronchitis at the age of 3 months but this soon resolved.