A Child with increased Ca++ & hyperphosphatemia is seen in: (A) Vitamin D dependent rickets, (B) Vitamin D resistant rickets, (C) Renal osteodystrophy, (D) Hypophosphatasia
Answer is C. Ans. c (Renal osteodystrophy). (Ref. Harrison Medicine, 18th/Ch.44, 279, Nelson, Paediatrics, 17th/223)# The principal clinical consequences of hyperphosphatemia are hypocalcemia and systemic calcification.# Ectopic calcification occurs in untreated, chronic renal failure with severe hypercalcemia and in vitamin D intoxication.# Tumor calcinosis is rare inherited disorder in which hyperphosphatemia is associated with ectopic calcification.# Vitamin D intoxication causes excessive gastrointestinal absorption of both Ca++ and Ph++ and suppression of PTH by hypercalcemia causes decrease in renal phosphorous excretion.# Hyperphosphatemia in hyperthyroidism or acromegaly is also associated with hypercalcemia.