RESUMO
Seizures are the most common disorder of the central nervous system in childhood and constitute a significant number of admissions to the pediatric emergency departments. The aim of this study is evaluate the etiology of hypocalcemic seizures in pediatrics. A single-center, hospital based descriptive study was done in the academic referral center for hypocalcemic seizure of Tehran University of Medical Sciences, Iran. Data was evaluated based on the medical records of each patient. Case files of these children's were analyzed for age at presentation, sex, weight, clinical features, biochemical parameters [serum calcium, magnesium, phosphorus and alkaline phosphatase] ,type of seizure, history of previous seizure and history of drug intake. A total 38 children with hypocalcemic seizure, consisting of 19 boys and 19 girls, with ages ranging from one month to 14 years, were enrolled in this study. The most common patterns of seizures were generalized seizures [83.8%]. the mean levels of serum alkaline phosphatase was significantly greater in patients under the age of 2 years [1234 +/- 541.03] rather above than 7 years of age [922.75 +/- 147.45] [p = .021]. Rickets was the commonest cause of seizures rickets were diagnosis in 80.8% subjects under 2 years of age, whereas none of those over 7 years old had not rickets , these results were statistically significant [p = .015]. Current observational study indicates that rickets could be a major cause of hypocalcemic convulsion in infants and children. Screening children presenting with hypocalcemic convulsions for rickets and/or other cause of hypocalcemia can help in early diagnosis and institution of specific therapy
RESUMO
Magnesium [Mg] is the second most abundant intracellular cation and is involved in numerous physiological functions, including protein folding, intracellular signaling and enzyme catalysis. It has been shown that magnesium deficiency exacerbates pulmonary airways hyperreactivity. Several studies suggest that magnesium level has no effect on asthma but others had shown a contributory effect. Because of its intracellular abundance, the aim of this study was to determine if there was any difference in plasma and intracellular Mg concentrations of children with acute asthma compared to non asthmatic children. Twenty nine patients with acute asthma aged 2 to 11 years admitted to the emergency department of hospital and 37 non asthmatic children with the same age were included in our study. O.5 mL of heparinized whole blood samples of patients who were meeting inclusion criteria at the onset of admission with bronchoconstriction and before using any medication was drawn and it was immediately sent to the laboratory. Plasma and erthrocytes were separated and stored at -20C and later their Mg levels were quantified with atomic absorption spectrophotometry method. The average plasma and intracellular magnesium levels in patients were [0.79 +/- 0.098 mmol/L] and [1.17 +/- 0.27 mmol/ L] respectively. Results of 37 non asthmatic persons [plasma [0.85 +/- 0.1 mmol/L] and erythrocytes [1.33 +/- 0.21 mmol/ L]] showed that there was no significant difference between plasma Mg levels in two groups [p 0.06] but intracellular magnesium level was significantly lower [p 0.03] in patients group. These results indicate that intracellular Mg level may be a more accurate method to assess Mg level in patients with asthma. Hence, determination of Mg concentration in erythrocytes may be used in evaluation of asthma pathophysiology. There are recommendations for using intravenous Mg sulfate in acute asthma, and this study supports the rational for using it in emergency departments for acute severe asthma