I would like to ask about the calcium levels in a baby who was undergoing repeated chemistry blood tests for a few months. First test was when the baby was 4 months old. each time the baby had elevated calcium levels. the baby is 13 months old now and only one out of 4 blood tests has shown normal calcium levels. this baby when 2 weeks old had also a rib fracture and easy bruising. twice there were some problems with parathyroid hormone level- 0nce too low once too high. regardless of this the court accused the father of the baby that he has caused the rib fracture- there is no evidence for that and the doctor experts disagree with this opiion. My question is what kind of illness could cause rib fracture, easy bruising and wrong calcium levels. Can judge ignore the medical evidence? a very important info is also that mother was an insuline based diabetic and baby was premature and uder phototherapy for 27 hours. mother has a lump on her thyroid and the baby had his first blood tests for chemistry done 4 months after the finding of rib fracture. we are looking for medical evidence that will support our opinion that the baby had bone problems when born and maybe calcium level are also responsible for easy bruising??? please answer asap as this will have very big impact on the case. Best regards.Monika
I'll do my best to answer your question. If you're available for chat, let's get started. If not, I can switch to an e-mail format.
There are no temporary conditions that I am aware of that would cause a rib fracture in a newborn. High calcium levels can cause easy bruisability, but if the calcium levels are still a bit high and he no longer has easy bruisability then that's a difficult argument to make. The mother's diabetes and the phototherapy should have no bearing on the situation. Certainly premature babies are more fragile than full-term babies if the baby was home by 2 weeks of age when the rib fracture was discovered then he couldn't have been more than a couple weeks premature and this, again, would be a non-issue.
Any medical condition that would cause the easy fracturing of bones would have persisted (for example, osteogenesis imperfecti, in which children have multiple breaks of even larger bones) and there would have been more fractures than just a rib.
I know this information likely isn't what you were hoping to hear, but I do hope you will click "accept" so that I may be compensated for the time I have spent assisting you. Feel free to reply with questions/clarifications.
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what about hypercalcemia or hypocalcemia
how about the phototherapy -induced hypocalcemia
how low is the probability of a premature two weeks child to have the rib fractured, both doctors said it is extremaly rare
could you describe how high calcium levels are causing bruising?
why does calcium levels have an influance on bruisability
bruises were discovered many times also later when baby was not at home
what about conditions like
you did not say a word about this.
please go into more detail.
SO sorry. I didn't see that you had posted back to me last night.Williams Syndrome is a genetic condition. Most of those children have a cardiac defect and they also have specific physical findings of the syndrome. If this baby is otherwise well Williams Syndrome is highly unlikely.Hypocalcemia means low calcium. You have only mentioned that his calcium level has been too high, not too low.Hypercalcemia means high calcium. If his calcium levels are consistently high then he would have hypercalcemia. It's important to distinguish which test is done, however, as a total calcium may be high but the ionized calcium may be normal. The ionized calcium is what the body actually sees to use and that is the more important number. Also important is how high the calcium level actually is and if they are using a pediatric reference lab for the reported "Normal" range of values. If it's, say, 0.1 or 0.2 high that's likely not a concern.Rib fractures without trauma in an infant are very unusual. They typically result from an infant being squeezed around the chest.It sounds like there has not been a consistent indication of parathyroid dysfunction that would explain the elevated calcium level.Phototherapy has been seen to cause low calcium levels in jaundiced infants. Again, you describe high calcium levels, not low.High calcium isn't a typical cause of bruising but there is an association. I can't tell you why bruising is sometimes seen with high calcium and could find no reference that explained the relationship.If the baby is now 13 months old and any of these issues were the cause of the rib fracture one would expect to see continued problems in the child now (repeated fractures, etc).